Humana Medical Economics Consultant in Miramar, Florida

Role:Medical Economics Consultant *Assignment: *Senior Products Retail *Location: *Miramar, FL

Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associates to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. At Humana, we’re seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry as a whole.

Assignment Capsule

Be a part of the Financial World- Provide leadership and direction while improving financial processes and procedures.

Humana is seeking a Medical Economics Consultant who will perform forecasting and analysis of data reporting and planning, profit improvement initiatives and on various departmental projects, using the results you generate to create financial reports. You will also act as a Finance liaison, partnering with associates from other business areas on special projects. * Develop methods and criteria for measuring and summarizing data for complex analyses * Maintain and review various system reconciliations between source systems and financial and operational reporting processes * Prepare and present financial data to management and clients for review and decision making * Research and analyze financial information necessary to support internal and external audit activity * Perform Capitation analysis * Develop custom code for physician and facility utilization repricing and ad hoc reporting * Re-price, analyze, trend, and compare facility, physician, and pharmacy utilization to contracted rates, Medicare Allowables, DRG, ASCAPC, Medicaid and Commercial Allowables * Compare and contrast various facility payment arrangements * Build reconciliation systems, migrating data to a single platform and aligning Humana’s internal reporting with the Enterprise Data Warehouse * Create custom Reports utilizing SSRS / Crystal Reports. * Perform ad hoc financial reporting


Role Essentials * Bachelor’s Degree in Finance, Accounting or a related field * Comprehensive knowledge of Microsoft Office applications including Access, Excel and multi-dimensional databases * Must be proficient with SQL Server - build complex queries * Strong analytical skills * Strong data manipulation skills

Role Desirables * Master’s Degree in Business Administration or a related field * Previous experience working with healthcare data * Understanding of CMS reimbursement - Medicare to providers on a FFS basis * Prior budgeting and planning experience Reporting Relationships * You will report to a Finance Manager. This area is under the leadership of the SVP & Chief Financial Officer. Additional Information

At Humana, we’re also committed to making the resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. We know your well-being is important to you, and it’s important to us too. If you share our passion for helping people, we likely have the right place for you at Humana.

After applying, we encourage you to join our Talent Network as well, so you can stay informed and up to date on what’s happening around our organization in the changing world of healthcare.

Title: Medical Economics Consultant

Location: FL-Miramar

Requisition ID: 178877