Note: The job is a remote job and is open to candidates in USA. Privia Health is seeking a senior analyst for its Medicare Value-Based Care Programs Analytics team. The role supports Accountable Care Organizations in the MSSP program by tracking performance, communicating wins and issues, and providing actionable insights for data-driven decisions.
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
- 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 preferred; 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 preferred
- Snowflake experience preferred
Benefits
- Medical, dental, vision, life, and pet insurance
- 401K
- Paid time off
- Other wellness programs
- Annual bonus targeted at 10%
- Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
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