Note: The job is a remote job and is open to candidates in USA. Privia Health is seeking a Senior Analyst to support its Accountable Care Organizations in the Medicare Shared Savings Program. The role tracks program performance, communicates wins and issues, and provides actionable analytics to support data-driven decision-making.

Responsibilities

• Build & Track Key Performance Metrics (KPIs): Track patient attribution, cost, utilization, risk stratification, and quality performance
• ACO & Provider Performance Tracking: Build actionable analytics for participating Taxpayer Identification Numbers (TINs) and providers that highlight actionable spend anomalies
• HCC Risk Score Optimization: Evaluate CMS HCC risk adjustment scores to identify performance gaps across the provider network
• Benchmark & Risk Modeling: Build ad-hoc models to track the ACO’s actual expenditures against CMS-established historical and regional benchmarks
• CCLF Data Management: Analyze CMS CCLF claims data to monitor total cost of care, out-of-network leakage, and utilization trends
• Regulatory Changes: Champion understanding of policy and regulations in Value Based Care (VBC) Programs with emphasis in the MSSP
• Collaborate with IT, ACO leaders, and Operations teams to help ensure Privia Health’s success in the MSSP program

Skills

• 2+ years of professional experience
• Healthcare (e.g. public health) or quantitative major (e.g. engineering, analytics, economics, actuarial sciences, statistics)
• Experience in healthcare claims data, EMR, hospital admission and discharge data, healthcare codes (CPT/HCPCS/provider specialty, diagnosis, place of service, revenue), healthcare claims adjudication (claim payments, adjustment/reversals, denials), healthcare claims processing
• Intermediate level experience with SQL and SAS
• Ability to communicate complex assessments and insights derived from data, CMS guidelines, ACOs' performance indicators, regional, and national healthcare trends to a variety of audiences
• Ability to distill analytical findings into clear insights and action steps
• Ability to translate complex business problems to technical requirements and design solutions
• Ability to remain flexible with changing priorities
• Relationship builder
• Critical thinker
• Proactive and self-motivated
• Bachelor's Degree
• Snowflake experience

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Life insurance
• Pet insurance
• 401K
• Paid time off
• Other wellness programs
• Eligible for an annual bonus targeted at 10%
• Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost
• Remote work

Company Overview