Health Economics and Outcomes Research Specialist

Responsibilities: Interpret and analyze medical claims utilizing ICD-10-CM, CPT, HCPCS, DRG, and related coding systems. Analyze healthcare utilization, claims, reimbursement, and outcomes data to identify trends, opportunities, and risks. Develop dashboards, reports, and financial models using Microsoft Excel and other analytical tools. Create and maintain complex spreadsheets, pivot tables, data visualizations, and forecasting models. Conduct statistical analyses to support business, clinical, and market access decisions. Interpret findings and present actionable recommendations to leadership and cross-functional teams. Support the design, execution, and interpretation of HEOR studies and real-world evidence initiatives. Assist in preparing value dossiers, payer evidence packages, and health economic models. Evaluate clinical, economic, and quality-of-life outcomes associated with healthcare interventions. Analyze payer contracts, reimbursement structures, and coverage policies. Support payer negotiation strategies through financial and utilization analyses. Monitor changes in commercial, Medicare, and Medicaid reimbursement environments. Assess market access implications of pricing and coverage decisions. Evaluate economic impacts of reimbursement changes and policy developments.

Qualifications: Strong knowledge of basic statistical methods and quantitative analysis. Advanced Microsoft Excel skills, including: Pivot TablesVLOOKUP/XLOOKUPComplex formulas Data modeling Experience with healthcare data analysis and reporting tools. Familiarity with SQL, Power BI, Tableau, R, SAS, or similar analytical platforms preferred. Strong understanding of: Medical terminology Healthcare delivery systemsICD-10, CPT, HCPCS, and DRG coding systems Healthcare claims processing Medicare, Medicaid, and commercial payer reimbursement Healthcare payment models and economics Payer contracting processes and strategies Strong analytical and problem-solving skills Excellent attention to detail Ability to interpret complex data and communicate insights clearly Strong written and verbal communication skills Ability to present findings to executive and non-technical audiences Project management and organizational skills Ability to manage multiple priorities in a fast-paced environment

Work Environment: Professional office setting Ability to work on-site 5 days a week at the Trumbull office. Prolonged sitting in front of a computer

Experience: 4+ years of healthcare analytics, reimbursement, market access, payer contracting, HEOR, or related experience. Experience working with healthcare claims, reimbursement, and outcomes data. Experience supporting payer, market access, or contracting initiatives.

Required: Bachelor's degree in Health Economics, Healthcare Administration, Public Health, Biostatistics, Economics, Finance, Data Analytics, Health Informatics, or a related field. Master's degree (MPH, MHA, MS, MBA, Health Economics, or related discipline) preferred.