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About
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!
Our people make all the difference in our success.
The Value-Based Care Analytics Manager, Intermediate develops, executes, and presents advanced analysis for clinical, financial and operational performance The Value-Based Care Analytics Manager, Intermediate develops, executes, and presents advanced analysis for clinical, financial and operational performance leveraging healthcare claims, clinical, operational and related data sources. This role plays an important part in day-to-day reporting and evaluation of the enterprise's value-based care and risk-based programs. This role requires entry-level knowledge of healthcare claims and claims analytics, clinical quality and quality metrics, clinical coding, care team operations and initiatives as well as analytics tools and techniques for the analysis of this data. This role is part of our Value-Based Care Institute (VBCI) products and analytics team and works with moderate direct supervision.
Essential Job Function
Data Analysis & Performance Monitoring
Analyze claims, clinical, and operational data to assess performance in value-based contracts.
Monitor key performance indicators (KPIs) such as total cost of care, quality measures, risk scores, utilization, and shared savings metrics.
Respond to ad hoc value-based care analytics requests.
Quality & Outcomes Analytics
Measure and evaluate quality performance against HEDIS, STAR ratings, CMS quality programs, and custom metrics.
Collaborate with clinical teams to identify gaps in care and improvement opportunities.
Cross-Functional Collaboration
Supports work across a variety of teams and stakeholders.
Prepares components for reporting and presentations.
Education
Required: Bachelor's Degree
Preferred: Master's Degree
Experience
Required:
Minimum of 2 years of experience.
Formal training or work experience in data analytics, data analysis, or data science
Experience working with two or more healthcare data types including claims data, payor revenue/premium data, payor supplemental data, clinical data including clinical quality metrics (HEDIS) and risk adjustment (HCCs), social determinants of health (SDOH), and operational data and KPIs.
Proven experience using data and analytics tools. Deep experience using SQL and at least one analytics or visualization tool (PowerBI, Tableau, SigmaComputing, or other).
Ability to communicate analysis to peers and stakeholders.
Genuine curiosity to dive deep into healthcare data and uncover insights and root causes.
Deep commitment to continuous learning as part of a cross-functional team that includes clinical and non-clinical stakeholders.
Preferred Experience:
Experience working in modern data infrastructure (Snowflake or Databricks).
Experience providing analysis and analytics for value-based contracts• Experience working within an agile delivery environment (DevOps)
Experience working with healthcare payors (CMS, regional and national payors)
Knowledge of and experience with healthcare claims data and related claims analytics tools (such as Milliman's MedInsight, MedeAnalytics, Tuva or claims analytics tools)
Knowledge of and experience with electronic health records (EHRs, such as Epic, Cerner, eCW, Allscripts, Athena)
Understanding of clinical workflows and clinical operations as they relate to value-based care and population health
Knowledge of and experience with population health management platforms (such as Epic's Value Based Care, Innovaccer, Arcadia, Lightbeam or other care management or population health platforms)
Work Shift : Days/No Weekends (United States of America)
On Call Required No
FTE: 1
Job Type: Full Time (40 Hours/Week)
Languages
- English
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