Note: The job is a remote job and is open to candidates in USA. Astrana Health is a physician-centric, technology-powered healthcare management company focused on value-based healthcare delivery. The Senior Analyst/Manager, Incentive Programs role owns the tracking, modeling, forecasting, and reporting of performance and earned revenue across health plan incentive programs. The role also prioritizes measures, identifies risks and opportunities, supports contract negotiations, and builds reliable data and reporting processes.
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
- 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
Skills
- 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
- This position is remotely based in the U.S
- This role is required to attend occasional in-person meetings with internal departments or health plan partners
- 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
Benefits
- This position is remotely based in the U.S.
Company Overview