Senior Analyst/Manager, Incentive Programs

Astrana Health Management; Alhambra, Northern (CA, KY); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Astrana Health Management is seeking a Senior Analyst/Manager, Incentive Programs to own the tracking, quantification, and reporting of performance and earned revenue across health plan incentive programs, spanning Medicare Advantage, Medicaid, Commercial, Exchange, and ACO populations.

These programs are a material and growing part of Astrana's revenue. Build models, monitor payouts, and deliver executive dashboards to inform strategy and action by senior leadership.

Qualifications

• Bachelor’s degree in a quantitative, public health, health policy, business, or related field, or equivalent practical experience.
• 3+ years (Senior Analyst) or 5+ years (Manager) of analytic experience in a health plan, IPA, MSO, or provider organization.
• Working knowledge of HEDIS and Medicare Stars measure specifications, including administrative, supplemental, and hybrid data sources.
• Familiarity with value-based care economics: pay-for-performance, shared savings, withholds, and capitated risk.
• Strong SQL and advanced Excel, working independently against large and imperfect datasets.
• Demonstrated experience building recurring executive reporting and translating analysis into a defensible recommendation.
• Comfort with ambiguity in source data, the judgment to know when a number is good enough to act on, and the discipline to state the confidence level.
• Excellent written and verbal communication with senior executives, and the accountability to manage multiple concurrent reporting cycles

Responsibilities

• Maintain a current inventory of health plan incentive programs across all lines of business, including measure sets, payout structures, attainment thresholds, gates, data requirements, and payment timelines.
• Translate contract and program terms into a quantified revenue opportunity model at the plan, market, IPA, and measure level, and maintain a running view of dollars available, earned to date, and still achievable.
• Quantify the marginal value of each incremental gap closed so effort and spend can be directed toward the highest yield measures.
• Monitor performance against payout thresholds throughout the year, with attention to measures sitting near a tier boundary in either direction.
• Identify high value measures using dollar weight, distance to threshold, denominator size, remaining runway, and feasibility, and set internal targets tied to payout tiers rather than generic benchmarks.
• Provide early warning when projected performance will miss a threshold, while there is still time to intervene.
• Produce monthly executive reporting covering year to date performance and revenue earned, projected year end performance and revenue, and change versus prior month and prior year with drivers.
• Build dashboards and recurring reporting that are legible without an analyst present, and present findings, risks, and recommendations to senior leadership and in board, health plan, and market reviews.
• Maintain a consistent, documented, auditable projection methodology so month over month movement reflects real performance change rather than methodology drift.
• Surface the largest revenue opportunities and downside risks with quantified impact, a recommended owner, and a recommended action, and track them to resolution.
• Reconcile Astrana's internal performance view against health plan reported results, investigate variances, and identify systemic causes including missing supplemental data, encounter submission gaps, attribution errors, and measure logic misalignment

Skills

SQL

Excel Advanced

Data analysis

Communication

BI tools

Education

Bachelor’s degree in a quantitative field

Tools

Power BI

Tableau

Looker

Python

R

Job description

Senior Analyst/Manager, Incentive Programs

Department: Quality - Risk Adjustment

Employment Type: Full Time

Location: 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801

Reporting To: Jeremy Jackson

Compensation: $90,000 - $130,000 / year

Description

About the RoleAs Senior Analyst/Manager, Incentive Programs at Astrana Health, you will own the tracking, quantification, and reporting of performance and earned revenue across the health plan incentive programs in which Astrana participates, spanning Medicare Advantage, Medicaid, Commercial, Exchange, and ACO populations.

These programs are a material and growing share of Astrana's earned revenue, but terms, measure sets, payout curves, and data requirements differ by plan, line of business, and market. This role brings one quantified view to that landscape: what dollars are available, what we are on pace to earn, what we are at risk of leaving on the table, and where an incremental unit of operational effort produces the greatest return.

What You'll Do

Incentive Program Inventory & Revenue Opportunity Modeling

• Maintain a current inventory of health plan incentive programs across all lines of business, including measure sets, payout structures, attainment thresholds, gates, data requirements, and payment timelines
• Translate contract and program terms into a quantified revenue opportunity model at the plan, market, IPA, and measure level, and maintain a running view of dollars available, earned to date, and still achievable
• Quantify the marginal value of each incremental gap closed so effort and spend can be directed toward the highest yield measures

Performance Monitoring & Measure Prioritization

• Monitor performance against payout thresholds throughout the year, with attention to measures sitting near a tier boundary in either direction
• Identify high value measures using dollar weight, distance to threshold, denominator size, remaining runway, and feasibility, and set internal targets tied to payout tiers rather than generic benchmarks
• Provide early warning when projected performance will miss a threshold, while there is still time to intervene

Executive Reporting, Forecasting & Risk Identification

• Produce monthly executive reporting covering year to date performance and revenue earned, projected year end performance and revenue, and change versus prior month and prior year with drivers
• Build dashboards and recurring reporting that are legible without an analyst present, and present findings, risks, and recommendations to senior leadership and in board, health plan, and market reviews
• Maintain a consistent, documented, auditable projection methodology so month over month movement reflects real performance change rather than methodology drift
• Surface the largest revenue opportunities and downside risks with quantified impact, a recommended owner, and a recommended action, and track them to resolution
• Reconcile Astrana's internal performance view against health plan reported results, investigate variances, and identify systemic causes including missing supplemental data, encounter submission gaps, attribution errors, and measure logic misalignment

Cross-Functional Strategy & Data Management

• Partner with the Chief Quality Officer and the President of Physician Enterprise to inform strategy and resource allocation across Quality, Utilization and Care Management, Encounter Submission, and Member Experience
• Support health plan contract negotiation with analysis of historical performance, achievability of proposed thresholds, and expected value under alternative terms
• Ingest, normalize, and reconcile data from plan reports, portal extracts, flat files, claims and encounter data, EMR feeds, and vendor files into repeatable, documented pipelines
• Establish data quality checks and reconciliation controls, document known data limitations, and partner with data engineering on durable reporting infrastructure as the function scales

Qualifications

• Bachelor’s degree in a quantitative, public health, health policy, business, or related field, or equivalent practical experience
• 3+ years (Senior Analyst) or 5+ years (Manager) of analytic experience in a health plan, IPA, MSO, or provider organization
• Working knowledge of HEDIS and Medicare Stars measure specifications, including administrative, supplemental, and hybrid data sources
• Familiarity with value-based care economics: pay-for-performance, shared savings, withholds, and capitated risk
• Strong SQL and advanced Excel, working independently against large and imperfect datasets
• Demonstrated experience building recurring executive reporting and translating analysis into a defensible recommendation
• Comfort with ambiguity in source data, the judgment to know when a number is good enough to act on, and the discipline to state the confidence level
• Excellent written and verbal communication with senior executives, and the accountability to manage multiple concurrent reporting cycles

Preferred Qualifications

• Direct experience with Medicare Advantage Star Ratings, Medicaid quality withhold or incentive programs, or ACO REACH and MSSP quality reporting
• Experience reconciling internal performance calculations against health plan reported results, and reading and operationalizing health plan incentive contract language
• Proficiency with BI tools (Power BI, Tableau, Looker) and with Python or R

Environmental Job Requirements and Working Conditions

• This position is remotely based in the U.S. The home office is located at 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801.
• This role is required to attend occasional in-person meetings with internal departments or health plan partners.
• The national target pay range for this role is between $90,000 - $130,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.