Specialist, Medical Economics Optimization

General:

1. The Specialist, Medical Economics Optimization is responsible for conducting comprehensive analyses of medical cost, pharmacy, and revenue data to identify trend drivers and affordability opportunities.
2. Understand the Daman strategy and business decisions to support managers in making informed, fact-based decisions.
3. Access, manage, and perform complex queries; analyse and interpret data; prepare information assets and data extracts.
4. Develop and maintain distinctive expertise in specific analytical tools such as SQL, or Excel, Power BI and others demonstrating independence and proactivity.
5. Work closely with clinical teams, network, IT departments, and other stakeholders to ensure accurate data collection, reporting, and implementation of cost optimization and improvement strategies.

Medical Economics

Performance Metrics Development:

1. Develop and maintain affordability and policy analysis queries to measure the performance of the business and the financial impact of DoH standards/policies.
2. Generate regular reports on performance metrics, including utilization and unit cost trends and areas of concern for internal and external stakeholders

Data Analysis and reporting:

1. Perform data reporting and analysis of recurring and ad-hoc report requests.
2. Support the leadership team with initiative and health outcomes reports.

Dashboard Management:

1. Develop dashboards using Power BI for Provider Network, Clinical Quality and Disease Management programs.
2. Update the dashboards to ensure they accurately reflect current performance data and trends.
3. Customize dashboards to meet the needs of various stakeholders and facilitate data-driven decision-making.

Data Management:

1. Maintain accurate and up-to-date business portfolio performance databases and records.
2. Utilize data management tools and software to streamline data collection, analysis, and reporting processes.
3. Ensure data management procedures and projects adhere to established timelines and processes.
4. Act as the point of contact for external vendors to optimize the technical operations of database management and dashboards.
5. Collaborate with the ITS department to improve IT systems and act as a focal point for reporting issues.

Key Requirements and Qualifications

• Minimum 5 years of experience in healthcare data extraction and clinical performance analysis
• Proficiency in data analysis tools and software (e.g. Excel, SQL, Statistical Analysis software, PowerBI, Tableau)
• Experience working with CPT, ICD 10 & DRG coding systems.
• Ability to work collaboratively with multidisciplinary teams.
• Excellent communication and presentation skills.
• Bachelor’s degree required; strongly preferred fields are related to Computer Science or Programming, Statistics or Mathematics, Health Economics or Healthcare Management
• Master’s degree is preferred

Skills and Competencies

• Must have SQL/SAS Analytics experience; hold solid analytical skills and data mining aptitude
• Advanced Microsoft Office Applications and Power BI
• Advanced quantitative and analytical skills such as regression analysis, time series analysis and inferential statistics
• Strong attention to detail and high degree of speed and accuracy
• Excellent communication, reporting, presentation, negotiation and interpersonal skills
• Good knowledge of health care analytics with background knowledge of various medical cost blocks and trends (e.g., pharmacy, laboratory, DRG’s, E&M etc.)
• Very good command of written and spoken English; knowledge of Arabic language is an advantage
• Very good planning, forecasting, execution and problem-solving skills
• Results oriented whilst ensuring high quality of work