Note: The job is a remote job and is open to candidates in USA. Privia Health is seeking a Senior Analyst to support its Accountable Care Organizations in the Medicare Shared Savings Program. The role tracks program performance, communicates wins and issues, and provides actionable analytics to support data-driven decision-making.
Responsibilities
- Build & Track Key Performance Metrics (KPIs): Track patient attribution, cost, utilization, risk stratification, and quality performance
- ACO & Provider Performance Tracking: Build actionable analytics for participating Taxpayer Identification Numbers (TINs) and providers that highlight actionable spend anomalies
- HCC Risk Score Optimization: Evaluate CMS HCC risk adjustment scores to identify performance gaps across the provider network
- Benchmark & Risk Modeling: Build ad-hoc models to track the ACO’s actual expenditures against CMS-established historical and regional benchmarks
- CCLF Data Management: Analyze CMS CCLF claims data to monitor total cost of care, out-of-network leakage, and utilization trends
- Regulatory Changes: Champion understanding of policy and regulations in Value Based Care (VBC) Programs with emphasis in the MSSP
- Collaborate with IT, ACO leaders, and Operations teams to help ensure Privia Health’s success in the MSSP program
Skills
- 2+ years of professional experience
- Healthcare (e.g. public health) or quantitative major (e.g. engineering, analytics, economics, actuarial sciences, statistics)
- Experience in healthcare claims data, EMR, hospital admission and discharge data, healthcare codes (CPT/HCPCS/provider specialty, diagnosis, place of service, revenue), healthcare claims adjudication (claim payments, adjustment/reversals, denials), healthcare claims processing
- Intermediate level experience with SQL and SAS
- Ability to communicate complex assessments and insights derived from data, CMS guidelines, ACOs' performance indicators, regional, and national healthcare trends to a variety of audiences
- Ability to distill analytical findings into clear insights and action steps
- Ability to translate complex business problems to technical requirements and design solutions
- Ability to remain flexible with changing priorities
- Relationship builder
- Critical thinker
- Proactive and self-motivated
- Bachelor's Degree
- Snowflake experience
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- Pet insurance
- 401K
- Paid time off
- Other wellness programs
- Eligible for an annual bonus targeted at 10%
- Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost
- Remote work
Company Overview