Senior Medical Economics Analyst

AHCCCS is Arizona’s Medicaid agency, driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. The agency is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility. Employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities.

About the role

AHCCCS is seeking a Senior Medical Economics Analyst to join the Office of Data Analytics within the Information Services Division. This position plays a key role in turning complex Medicaid data into clear, actionable insights that support decision-making across the agency. Help shape healthcare decisions for more than 2 million Arizona Medicaid members by using advanced analytics and data storytelling to influence policy, improve health outcomes, and identify opportunities to reduce healthcare costs across one of the nation's largest Medicaid programs.

This role regularly partners with executive leadership, program leaders, and healthcare stakeholders to deliver insights that influence policy decisions, operational strategy, and statewide healthcare initiatives. You will analyze claims, encounters, membership, utilization, financial, and other healthcare data to identify trends, evaluate cost and quality drivers, and develop recommendations that support program operations, strategic planning, and healthcare policy decisions. This opportunity is ideal for an experienced healthcare analytics professional who enjoys solving complex problems, working with large datasets, developing meaningful visualizations, and communicating findings to both technical and non-technical audiences.

Responsibilities

• Analyze Medicaid claims, encounters, pharmacy, utilization, membership, demographic, provider, and other healthcare datasets to identify trends, risks, cost drivers, utilization patterns, quality outcomes, and opportunities for improvement.
• Conduct research and perform complex analyses to support business operations, healthcare programs, financial management, and strategic initiatives.
• Develop recommendations based on data findings and communicate implications to stakeholders.
• Develop, maintain, and enhance recurring and ad hoc reports, dashboards, scorecards, and key performance indicators that support business operations and executive decision-making.
• Monitor healthcare costs, utilization, quality measures, and program performance, ensuring accurate and timely reporting for internal customers, agency leadership, and other stakeholders.
• Provide analytical support for organizational initiatives by evaluating business problems, assessing operational and financial impacts, identifying improvement opportunities, and developing data-driven recommendations.
• Support long-term planning efforts through predictive analysis, trend identification, forecasting, and evaluation of program outcomes and effectiveness.
• Translate complex analytical findings into clear and actionable business insights for technical and non-technical audiences.
• Prepare executive summaries, presentations, data visualizations, and written recommendations that support informed decision-making.
• Present findings to business partners, management, and agency leadership and respond to follow-up analytical requests.
• Partner with internal business units, healthcare program teams, finance staff, operational leaders, and other stakeholders to understand business needs, define analytical requirements, and deliver meaningful solutions.
• Provide subject matter expertise on healthcare data, reporting methodologies, performance metrics, and analytical findings to support operational, financial, and strategic decisions.
• Promote data integrity, consistency, and appropriate use of healthcare data by supporting data governance, validation, documentation, and quality improvement activities.
• Utilize analytical and business intelligence tools, programming languages, healthcare coding systems, and healthcare data sources to ensure accurate analysis and reporting.
• Contribute to knowledge sharing, process improvement, and departmental best practices.

Requirements

• Bachelor’s degree in Mathematics, Statistics, Economics, Finance, or healthcare-related discipline and/or 10 years of experience in business analysis, healthcare analytics, medical economics, data analysis, or closely related field.
• Experience working with healthcare data including but not limited to medical claims data, Medicaid data, Medicare data, or similar healthcare datasets.
• Experience querying, summarizing, and manipulating data using SQL, SAS, Python, R, Machine Learning methods, Cognos, PowerBI, or similar technologies.
• Strong ability to analyze complex datasets and communicate findings in a clear and actionable way.

Qualifications

• Master’s degree in Mathematics, Statistics, Economics, Finance, or healthcare-related discipline (preferred).
• Medicaid or Medicare experience, especially with claims, encounter, utilization, pharmacy, or managed care data (preferred).
• Experience preparing dashboards, reports, or data visualizations using PowerBI or comparable data visualization tool (preferred).
• Experience explaining complex methodologies and presenting findings and recommendations to both technical and non-technical audiences (preferred).
• Familiarity with AHCCCS business needs, PIMMIS, encounter processing, managed care organizations, CMS policy, or healthcare data governance concepts (preferred).

Skills

• Healthcare data concepts, including medical claims, pharmacy claims, utilization management, demographic data, and healthcare coding systems.
• Data analysis, data mining, reporting, analytics, and modeling of complex data sets.
• Business intelligence and reporting tools such as IBM Cognos, Power BI, or equivalent platforms.
• Data management concepts, practices, procedures, and data governance principles.
• Medicaid, Medicare, managed care, encounter processing, and CMS-related policy concepts.
• Strong analytical, research, and problem-solving skills.
• Excellent attention to detail and commitment to data quality.
• Strong written, verbal, interpersonal, and presentation skills.
• Strong customer service and business partner engagement skills.
• Ability to balance, prioritize, and organize multiple tasks and assignments.
• Ability to work collaboratively with teams across the agency and with external business partners.
• Ability to synthesize feedback and adjust analysis, reporting, or communication approaches as needed.
• Ability to build strong working relationships inside and outside the organization.
• Ability to organize data in ways that support meaningful inference, conclusion, and decisions.
• Ability to understand and anticipate the needs and priorities of internal and external customers.

Pre-Employment Requirements

• Successfully pass fingerprint background check, prior employment verifications, and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions.
• Travel may be required for State business.
• Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12). If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, the following requirements apply: Driver’s License Requirements.
• All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

Benefits

• 10 paid holidays per year.
• Paid Vacation and Sick time off (13 and 12 days per year respectively) – start earning it your first day (prorated for part-time employees).
• Paid Parental Leave – up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child.
• Other Leaves – Bereavement, civic duty, and military.
• A top-ranked retirement program with lifetime pension benefits.
• A robust and affordable insurance plan, including medical, dental, life, and disability insurance.
• Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications).
• RideShare and Public Transit Subsidy.
• A variety of learning and career development opportunities.
• Option of a full-time or part-time remote work schedule, improving work/life balance, job satisfaction, and productivity.

Retirement benefits include a lifetime pension benefit program administered through the Arizona State Retirement System (ASRS), a defined benefit plan providing lifelong income upon retirement. Participation is required for Long-Term Disability (LTD) and ASRS Retirement plan, with pre-tax payroll contributions beginning after a 27-week waiting period (prior contributions may waive the waiting period). A voluntary Deferred Retirement Compensation Program is also available through Nationwide, offering tax-deferred retirement investments via payroll deductions.

Pay

$70,000 - $75,000