Professional Non-Clinical

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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)

Licensure/Certification/Listing

Work Shift :

Days/No Weekends (United States of America)

On Call Required

No

FTE:

1

Job Type:

Full Time (40 Hours/Week)

Bachelor's degree and 2+ years of analytics experience, including healthcare claims and other healthcare data. Requires deep SQL and analytics or visualization tool experience, communication skills, and value-based care knowledge.

Key Responsibilities

• analyzing data
• monitoring performance
• preparing reports

Skills & Tools

SQL, Power BI, Tableau, Sigma Computing, Snowflake, Databricks, DevOps, Milliman’s MedInsight, MedeAnalytics, Tuva, EHR, Epic, Cerner, eCW, Allscripts, Athena, Innovaccer, Arcadia, Lightbeam

Job Details

• Category: Data and Analytics
• Seniority: Entry Level
• Commitment: Full Time
• Workplace: Remote — United States
• Languages: English

About Conehealth

A healthcare organization focused on collaborative, sustainable, and high-quality care. — Industry: Healthcare