Senior Program Research Associate

Wellvana

Analytical role focused on Medicare claims data and cost modeling. Working independently to design surveillance logic and investigate claims patterns.

Posted 6/2/2026full-timeRemote • Tennessee • 🇺🇸 United StatesSeniorWebsite

Tech Stack

Tools & technologies

Amazon RedshiftBigQueryPythonSQLTableau

About the role

Key responsibilities & impact

Design, build, and maintain surveillance logic against Medicare claims data.
Develop and refine statistical thresholds and decision rules.
Manage surveillance data feeds — CMS claims refreshes, provider taxonomy data, eligibility events, post-acute episode chains.
Review flagged patterns, apply documented decision rules, and document findings.
Build and maintain benchmark adjustment models quantifying financial impact on ACO shared savings position.
Develop and deliver operational flags to care management and network teams.

Requirements

What you’ll need

Bachelor's degree in health economics, statistics, mathematics, health informatics, public health, computer science, or a closely related quantitative field.
5+ years of progressive experience in healthcare data analytics, health economics, or a closely related analytical field with demonstrated growth in scope and autonomy.
3+ years of direct, hands-on experience with Medicare claims data — CMS CCLF extracts, LDS files, or equivalent — including claim types (carrier, institutional, DME), revenue codes, HCPCS/CPT coding, and adjudication logic.
2+ years in a value-based care, ACO, or payer analytics environment.
2+ years applying health analytic methods: cost decomposition, utilization trending, risk adjustment analysis, population segmentation, or financial impact modeling.
3+ years SQL, Python, R or dbt required.
2+ years Snowflake (preferred), BigQuery, or Redshift.
2+ years BI platform (Sigma, Looker, Tableau, or Power BI).

Benefits

Comp & perks

Health insurance
Flexible work arrangements
Professional development opportunities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

healthcare data analyticsstatistical thresholdsdecision rulesbenchmark adjustment modelscost decompositionutilization trendingrisk adjustment analysispopulation segmentationfinancial impact modelingSQL