Value Based Care Analytics Manager Intermediate

Cone Health; Greensboro (NC); On-site; USD 85,000 - 110,000; Full time

Job summary

Cone Health in Greensboro, NC seeks an Intermediate Value-Based Care Analytics Manager to develop, execute and present advanced analytics for clinical, financial and operational performance. You will work within the Value-Based Care Institute to drive reporting and evaluation of value-based care and risk programs with moderate supervision.

Responsibilities include analyzing claims and data, monitoring KPIs, collaborating with clinical teams, and preparing components for reporting and

Qualifications

• Minimum 2 years of experience in data analytics or data science.
• Experience with healthcare data types including claims and clinical data.
• Ability to communicate analysis to peers and stakeholders.
• Familiarity with HEDIS or CMS quality programs is a plus.

Responsibilities

• Data Analysis & Performance Monitoring: analyze claims, clinical and operational data to assess value-based contract performance.
• Monitor KPIs such as total cost of care, quality measures, risk scores, utilization and shared savings.
• Respond to ad hoc value-based care analytics requests.
• Quality & Outcomes Analytics: measure quality against HEDIS, STAR, CMS programs and custom metrics.
• Collaborate with clinical teams to identify care gaps and improvement opportunities.
• Cross-Functional Collaboration: support work across multiple teams and stakeholders; prepare reporting components.

Skills

SQL

PowerBI

Tableau

Analytics tools

Communication

Curiosity

Cross-functional collaboration

2+ years experience

Education

Bachelor's Degree

Master's Degree

Tools

Milliman MedInsight

MedeAnalytics

Tuva

Snowflake

Databricks

Job description

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