Medicaid Economics Data Analyst - Full Time - Remote Role

Data Analyst III – Medical EconomicsLocation: Fully Remote (CST/EST preferred; CA candidates must start ~6:00am PST)Type: PermanentSalary: $85,000–$95,000 base + 8% target bonus Industry: Healthcare / Managed CareOverviewWe are expanding our Medical Economics team and are seeking a Data Analyst III with strong managed care analytics experience. This role focuses on Medicare, Medicaid, and Marketplace analytics, reimbursement methodologies, and financial performance insights that support affordability, quality, and MLR targets.The ideal candidate has hands-on experience working with large healthcare datasets, payment methodologies, and cross-functional stakeholders, with exposure to actuarial or medical economics workstreams.Key Responsibilities

• Analyze Medicare, Medicaid, and Marketplace data to support medical cost, utilization, and reimbursement insights
• Develop and maintain complex SQL queries to extract, validate, and analyze large datasets
• Perform financial and medical cost analyses related to payment and reimbursement methodologies (DRG, APC, EAPG)
• Build and maintain Power BI dashboards using DAX and Power Pivot to track KPIs, MLR, and QAI initiatives
• Create advanced Excel models using Pivot Tables, Power Query, nested formulas, and lookups to support financial modeling
• Collaborate with Medical Economics, Actuarial, Finance, and other cross-functional teams
• Support evaluation of Quality & Affordability Initiatives (QAI) and Medical Loss Ratio (MLR) performance
• Ensure data accuracy through validation, reconciliation, and documentation

Required Qualifications

• Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance, or related field
  • Equivalent experience considered
• 4+ years of experience working with large datasets, data management, and analytics
  • OR 2+ years of IT/data-focused experience with healthcare exposure
• Strong experience in Managed Care / Medical Economics analytics
• Demonstrated knowledge of payment and reimbursement methodologies (DRG, APC, EAPG)
• Advanced SQL skills (complex SELECTs, multiple JOINs, subqueries)
• Advanced Excel skills (Pivot Tables, Power Query, VLOOKUP/XLOOKUP, financial modeling)
• Power BI experience, including DAX and Power Pivot

Preferred / Nice-to-Have

• Experience with actuarial or financial analytics in a healthcare setting
• Exposure to Python and/or R
• Consulting experience within managed care or medical economics

Additional Notes

• No relocation available
• No sponsorship
• This is a new position due to team expansion
• Candidates with actuarial-adjacent experience or prior medical economics consulting backgrounds have been especially successful in this team

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