Minimum Qualifications

• Masters’ Degree or extensive medical economist experience exceeding minimum qualifications (includes bachelor’s degree plus experience)
  At least three (3) years of experience doing a broad base of senior level medical economic analyses.
• A good working knowledge of inpatient and outpatient medical industry operations or claims analysis to identify aberrant billing patterns.
• At least two (2) years’ experience acting as lead worker on complex medical analyses
• High level proficiency in SAS, SQL, data mining software and Microsoft Office Suite, including Access Excel, Power Point and Word.
• Experience in accessing using and analyzing complex medical information databases.
• (A good working knowledge of Medicaid/Medical Assistance a plus, but not required)

Role Description

Provide leadership in the design and conduct of:
Fiscal and program analyses to support Pennsylvania Medical Assistance Program decision-making processes.
Analyses to support medical assistance business operating decisions and for tracking, reporting and controlling of Medical Assistance costs.
Analyses to support the development of effective provider network management, reimbursement systems and strategies or identification of abuse or waste in the Medical Assistance program.
Cost benefit analyses for new Medical Assistance initiatives
Medical Assistance cost trend analyses by geography, services provider type, place of service and other factors to discover trends and suggest action plans.
Fiscal and impact analysis of potential cost containment
initiatives
Extract and analyze large data sets and perform analyses to determine whether targeted cost savings were achieved or identify future savings targets
Perform analysis of various data sets, recommend payment levels and provide fiscal impact estimates Development and maintenance of healthcare payment reconciliation systems Participate in meetings to advise Commonwealth staff on work results.

About Us:

TulaRay partners with clients to create staffing solutions that meet unique organizational needs. Our services are designed to reduce administrative burdens, protect your brand, and improve assignment time-to-fill. We believe that mutually successful client relationships are built on lasting quality and exceptional customer service. We pride ourselves on our uncompromising commitment to high-quality emergency management & healthcare personnel, while ensuring that our clients are taken care of with personalized attention. TulaRay manages total compliance and respectfully supports hundreds of professionals and patient-centered programs.

TulaRay is proud to be an affirmative action employer and is committed to providing equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you have a disability or special need that requires accommodation, please let us know by visiting our website at tularay.com