Specialist, Medical Economics Optimization
Daman - National Health Insurance Company Abu Dhabi
Job Description
General:
- 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.
- Understand the Daman strategy and business decisions to support managers in making informed, fact-based decisions.
- Access, manage, and perform complex queries; analyse and interpret data; prepare information assets and data extracts.
- Develop and maintain distinctive expertise in specific analytical tools such as SQL, or Excel, Power BI and others demonstrating independence and proactivity.
- 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:
- Develop and maintain affordability and policy analysis queries to measure the performance of the business and the financial impact of DoH standards/policies.
- 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:
- Perform data reporting and analysis of recurring and ad-hoc report requests.
- Support the leadership team with initiative and health outcomes reports.
Dashboard Management:
- Develop dashboards using Power BI for Provider Network, Clinical Quality and Disease Management programs.
- Update the dashboards to ensure they accurately reflect current performance data and trends.
- Customize dashboards to meet the needs of various stakeholders and facilitate data-driven decision-making.
Data Management:
- Maintain accurate and up-to-date business portfolio performance databases and records.
- Utilize data management tools and software to streamline data collection, analysis, and reporting processes.
- Ensure data management procedures and projects adhere to established timelines and processes.
- Act as the point of contact for external vendors to optimize the technical operations of database management and dashboards.
- Collaborate with the ITS department to improve IT systems and act as a focal point for reporting issues.
- 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.
- Bachelors degree required; strongly preferred fields are related to Computer Science or Programming, Statistics or Mathematics, Health Economics or Healthcare Management
- Masters degree is preferred
- 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, DRGs, 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
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