Address:  150 N. 18th Ave, Phoenix, AZ 85007

Must Reside in Arizona.

Salary:  $70,000 - $75,000

Grade: 26

FLSA Status: Exempt 

Closing Date: Open Until Filled

This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures.

A career in public service awaits you. COME JOIN OUR TEAM!

A great benefit of working for the State of Arizona is a fantastic work/life balance. State employees enjoy challenging work, popular remote work options, comprehensive health and wellness benefits, and career growth opportunities.

We are searching for someone who is analytical and detail-oriented, who can compile results and present complex data and insights to a variety of audiences, including Executive Leadership. The ideal candidate will demonstrate expertise in analytics, data interpretation, and trend analysis, coupled with strong communication and presentation skills. If you excel at articulating data-driven findings, responding thoughtfully to spontaneous questions, and conveying information in a clear and compelling manner to diverse audiences, we would like to have you on our team!  

What You'll Do:

The Senior Medical Economics Analyst produces data-driven analysis to support healthcare operations, collaborating with business areas to develop reports, dashboards, and actionable insights. The position identifies opportunities to better manage medical costs, evaluates cost reduction initiatives, and presents findings to internal partners and agency leaders. As part of the Medical Operations Analytical Review (MOAR) team, the role manages projects, prepares presentations, and supports agency initiatives to improve care.

This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures.

Major duties and responsibilities include but are not limited to:
• Collaborate with business areas to develop and monitor standard reporting packages and dashboards. This includes tracking key performance indicators, researching healthcare delivery topics, analyzing claims and membership data, and recommending solutions to address business challenges. Present analytical findings to internal partners and agency leaders, often leading discussions and providing deeper analysis. Identify and quantify opportunities to reduce medical costs and evaluate the effectiveness of cost reduction initiatives. Analyze healthcare utilization to detect patterns, variations, and outliers, and provide consultative support based on medical cost analysis.
• As part of the Medical Operations Analytical Review (MOAR) team, prepare for monthly presentations and manage both long- and short-term projects. Work collaboratively with AHCCCS leaders to achieve goals that improve member care. Ensure accurate and timely preparation of health plan economics analyses and reporting.
• Analyze and research aspects of AHCCCS, including utilization, unit cost drivers, performance metrics, operational targets, membership trends, and financial data by health plan and contract type. Transform data into actionable information through data visualization and support the development of action items by identifying outlier cost issues.
• Participate in agency initiatives, supporting staffing and results across all functions within AHCCCS and the Medical Economics unit. Develop and analyze processes to review financial data for senior leadership. Contribute to efforts that educate executives, employees, and customers about the strategic value of data as a business asset and decision-making tool.
• Support the development and training of team members and colleagues, fostering a collaborative and knowledgeable work environment.

Knowledge:
• Healthcare data and concepts including medical and pharmacy claims, utilization management and demographic data and healthcare industry coding systems ICD-10, CPT/HCPCS, Revenue Codes, and others as applicable
• Medicaid/Medicare programs and services
• Modeling of complex datasets
• Familiarity with health plan economics, cost reduction initiatives, and financial outcomes related to medical care
• Reporting and analytics
• Knowledge of AHCCCS utilization, unit cost drivers, performance metrics, membership trends, and contract types, AHCCCS business needs, operations and dependencies
• Power BI and/or equivalent BI tools
• Microsoft Excel, Word and PowerPoint
• PMMIS
• Data management concepts, practices, and procedures focusing on data governance
• Managed Care Organization and CMS policies

Skills:
• Strong customer service skills
• Excellent interpersonal, written, and oral communication skills (verbal, written, and presentation)
• Excellent problem-solving skills and attention to details
• Ability to extract, analyze, interpret, and present complex data; skilled in turning data into actionable insights and visualizations
• Proficient in developing and monitoring reporting packages and dashboards with key performance indicators
• Capable of managing long and short-term projects, tracking and documenting work from start to finish
• Strong skills in presenting findings and insights, leading discussions, and educating stakeholders about the strategic value of data
• Ability to provide consultative analysis and support to business partners and agency leaders

Abilities:
• Analyze healthcare utilization to spot patterns, variations, and outliers, and perform drill-down analysis to identify cost trend drivers
• Work collaboratively with agency leaders and team members to achieve goals and improve care
• Support the development and training of colleagues, contributing to a knowledgeable and effective team environment
• Participate in agency initiatives and support staffing to deliver results across medical economics functions
• Balance, prioritize and organize multiple tasks
• Synthesize feedback and adjust plans accordingly
• Resolve incidents/problems efficiently and effectively, recognizing customers’ competence levels, and approach each level appropriately
• Understand and anticipate needs and priorities of both internal and external customers
• Organize data in a way that facilitates inferences, conclusions, and decisions

Minimum:
• Bachelor’s degree in Mathematics, Statistics, Economics, Finance or healthcare related discipline and/or 2 years of experience in business analysis or equivalent. 2 years of Medicaid or Medicare experience working with healthcare data including but not limited to medical claims data at a medical insurance company or equivalent work history at a State or Federal level for these programs. 1 year of experience querying, summarizing, and manipulating data using SQL, SAS, Python, R, or PowerBI.

Preferred:
• Master’s degree in Mathematics, Statistics, Economics, Finance or healthcare related discipline. 5 years of Medicaid or Medicare experience preparing/presenting dashboards and data using a data visualization tool such as PowerBI. Experience clearly explaining complex methodologies and present findings and recommendations to both technical and non-technical audiences.

• Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions.
• Travel may be required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.)

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements.

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

Among the many benefits of a career with the State of Arizona, there are:
• 10 paid holidays per year
• Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
• Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child. Learn more about the Paid Parental Leave pilot program here.
• Other Leaves - Bereavement, civic duty, and military.
• A top-ranked retirement program with lifetime pension benefits
• A robust and affordable insurance plan, including medical, dental, life, and disability insurance
• Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications)
• RideShare and Public Transit Subsidy
• A variety of learning and career development opportunities

By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.

Learn more about the Paid Parental Leave pilot program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Lifetime Pension Benefit Program
• Administered through the Arizona State Retirement System (ASRS)
• Defined benefit plan that provides for life-long income upon retirement.
• Required participation for Long-Term Disability (LTD) and ASRS Retirement plan.
• Pre-taxed payroll contributions begin after a 27-week waiting period (prior contributions may waive the waiting period).

Deferred Retirement Compensation Program
• Voluntary participation.
• Program administered through Nationwide.
• Tax-deferred retirement investments through payroll deductions.

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing careers@azahcccs.gov.
Requests should be made as early as possible to allow time to arrange the accommodation. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.