Medical Economics Senior Analyst

Job Summary

Mass General Brigham Health Plan is seeking a Medical Economics Senior Analyst to oversee regulatory reports and financial analyses supporting external filings and internal interpretation of results. This role requires expertise in financial regulatory reporting and hands-on experience with CHIA, DOI, and CMS submissions.

About the Role

The Senior Analyst plays a crucial role in creating and delivering regulatory reports and financial analyses that align with Mass General Brigham Health Plan’s mission and strategic goals. They translate complex regulatory specifications into actionable data logic, ensuring accurate and timely report production, and identify key drivers of cost, utilization, and performance.

Responsibilities

• Translate complex regulatory specs into executable data logic, including mapping business definitions to claims, enrollment, pharmacy, and provider data sources.
• Own end-to-end reporting lifecycle: requirements intake, data extraction, transformation, validation, and submission support across recurring annual, quarterly, and monthly filings.
• Execute and enhance reporting workflows for key filings such as CHIA Pharmacy Rebate, RxDC, Premium, Relative Price, Total Medical Expenses and Alternative Payment Methods (TME-APM), Primary Care and Behavioral Health (PC-BH), and DOI utilization reports.
• Develop and maintain reusable code, parameterized logic, and standardized datasets to support repeatable reporting processes.
• Perform rigorous data validation, including reconciliation to prior submissions, financial systems, and BI tools to ensure accuracy and audit readiness.
• Document reporting processes at varying levels of maturity (checklist, step-by-step instructions, and comprehensive guides) to support continuity and scalability.
• Partner cross-functionally with Actuarial, Finance, Product, Pharmacy, and Network teams to source inputs, validate outputs, and resolve data gaps.
• Support internal reporting needs alongside external regulatory deliverables.

Requirements

• At least 5-7 years of experience in data analysis required.
• Experience running CHIA Pharmacy Rebate, RxDC, Premium, Relative Price, Total Medical Expenses and Alternative Payment Methods (TME-APM), Primary Care and Behavioral Health (PC-BH), and DOI utilization reports is highly preferred.
• Strong knowledge of relational databases, SQL, data visualization, and Business Intelligence tools, such as Tableau.
• Strong proficiency with Microsoft Office Suite, including Word, Excel, and PowerPoint.
• Ability to communicate complex workflows and data to a variety of audiences.
• Project management skills and/or experience are a plus.
• Knowledge and application of statistical analyses, including variance analysis and statistical significance preferred.
• Healthcare knowledge, particularly as it pertains to electronic medical record data, is preferred but not required.

Qualifications

• Bachelor's Degree required; experience can be considered in lieu of a degree.

Skills

• Strong knowledge of relational databases, SQL, data visualization, and Business Intelligence tools, such as Tableau.
• Strong proficiency with Microsoft Office Suite, including Word, Excel, and PowerPoint.
• Ability to communicate complex workflows and data to a variety of audiences.
• Project management skills and/or experience are a plus.
• Knowledge and application of statistical analyses, including variance analysis and statistical significance preferred.
• Healthcare knowledge, particularly as it pertains to electronic medical record data, is preferred but not required.

Benefits

We offer a competitive salary range of $79,560.00 - $115,720.80 annually, along with a benefits package that includes flexible work options, career growth opportunities, and much more. Employees also benefit from a comprehensive benefits program, including health insurance, retirement plans, and paid time off.

Pay

$79,560.00 - $115,720.80/Annual

Schedule

Monday through Friday, 8:30 AM - 5:00 PM Eastern

Additional Job Details

This is a remote role that can be done from most US states. Employees must use a stable, secure, and compliant workstation in a quiet environment. Teams video is required and must be accessed using MGB-provided equipment.