Senior Director, Value-Based Care Analytics and Medical Economics
Cardiovascular Associates of America - CVAUSA
full-time
Posted on:
Location: 🇺🇸 United States
Visit company websiteJob Level
Senior
Tech Stack
PythonSQL
About the role
- Lead CVAUSA's analytical capabilities for value-based care contracts, combining hands-on execution with team leadership
- Lead opportunity analyses for prospective VBC contracts, including financial modeling, risk assessment, contract structure development, contract evaluation and supporting negotiations
- Conduct performance analyses of existing VBC contracts across financial, operational, and clinical dimensions
- Execute sophisticated statistical analyses and predictive modeling to support contract optimization and risk management
- Oversee preparation and validation of medical claims reconciliations with VBC partners and maintain advanced analytical models for monitoring and forecasting
- Manage and develop a team of two analysts, provide mentorship, coordinate capacity, and prioritize analytical projects
- Serve as primary analytical representative in meetings with payer partners and external stakeholders and present findings to diverse audiences
- Collaborate internally with VBC leadership, payer relations, clinical and operations teams; report to Chief Data Officer
- Maintain expertise in healthcare claims data, risk adjustment methodologies, and VBC financial models; document reproducible methodologies
Requirements
- 7+ years of experience in healthcare data and analytics, with minimum 4+ years focused on value-based care, managed care, or health plan analytics
- Deep experience working with large medical and pharmacy claims datasets, including data normalization, reconciliation, and quality assessment
- Strong understanding of risk adjustment, IBNR, and other actuarial methodologies applicable to VBC contracts
- Advanced SQL skills (Snowflake preferred), Python for statistical analysis, Power BI development, and sophisticated Excel modeling
- 3+ years managing analytical teams with demonstrated ability to develop talent while maintaining hands-on technical contribution
- Experience with external facing customers in the business development and account management process as the primary analytics representative
- Bachelor's Degree in Actuarial Science, Mathematics, Statistics, Economics, Data Science, Healthcare Administration, or related quantitative field required
- Master's degree in relevant field preferred