Identify and quantify opportunities to optimize health outcomes, risk adjustment, clinical care quality, and population health
Contribute to projections and evaluations of financial impacts of programs and solutions on clinical care delivery, quality, and population health
Operate in dyad partnership with Manager of Medical Economics Analytics to deliver integrated analytics
Engage regularly with internal and external stakeholders across clinical, operational, and executive teams
Serve as trusted advisor translating complex data into actionable insights supporting cost containment and performance improvement
Lead a small team, provide guidance and support for analysts, create collaborative environment
Lead complex analyses focused on illness burden, population stratification, clinical quality performance, and risk adjustment
Create opportunity assessments, driver analyses, dashboards, and other analytic products
Develop and monitor KPIs for illness burden, clinical quality, and risk adjustment performance
Develop and implement best practices and standards ensuring data and analysis quality and alignment with enterprise standards
Requirements
Bachelor’s degree in a relevant field (e.g., public health, epidemiology, nursing, allied health, biostatistics, statistics, data science, health services research, healthcare administration, population health); Master’s degree strongly preferred
7+ years in healthcare, clinical and/or population health analytics in a payer, health system, or provider organization
1-2 years of people leadership experience required; 3 years strongly preferred
Proficiency in SQL and statistical programming (SAS, R, Python, etc.) for data extraction, manipulation, and analysis
Broad and deep expertise with diverse data sources: claims, clinical, notifications, pharmacy, lab, and social determinants of health
Experience with population health metrics and risk stratification methodologies
Experience and expertise in value-based care and alternative payment models
Strong communication and project leadership skills
Expertise with data visualization tools (Tableau, Power BI)
Experience with healthcare data platforms, risk scores, quality measurement, and clinical and business rules that segment populations by illness burden, disease states, and other risk factors