The Value-Based Care Analytics Manager, Intermediate develops, executes, and presents advanced analysis for clinical, financial and operational performance leveraging healthcare claims, clinical, operational and related data sources. This role plays an important part in day-to-day reporting and evaluation of the enterprise?s value-based care and risk-based programs. This role requires entry-level knowledge of healthcare claims and claims analytics, clinical quality and quality metrics, clinical coding, care team operations and initiatives as well as analytics tools and techniques for the analysis of this data. This role is part of our Value-Based Care Institute (VBCI) products and analytics team and works with moderate direct supervision.

Data Analysis & Performance Monitoring
o\tAnalyze claims, clinical, and operational data to assess performance in value-based contracts.
o\tMonitor key performance indicators (KPIs) such as total cost of care, quality measures, risk scores, utilization, and shared savings metrics.
o\tRespond to ad hoc value-based care analytics requests.
Quality & Outcomes Analytics
o\tMeasure and evaluate quality performance against HEDIS, STAR ratings, CMS quality programs, and custom metrics.
o\tCollaborate with clinical teams to identify gaps in care and improvement opportunities.
Cross-Functional Collaboration
o\tSupports work across a variety of teams and stakeholders.
o\tPrepares components for reporting and presentations.
EDUCATION:?\tFormal training or work experience in data analytics, data analysis, or data science. A bachelor?s degree is considered to meet 3 years of experience; a master?s degree is considered to meet an additional 1 year of experience, and a doctorate degree is considered to meet an additional 2 years of experience. Other relevant formal training in data analytics and/or healthcare analysis and operations may be considered on a case-by-case basis.
EXPERIENCE:?\tMinimum of 5 years of experience. Experience working with two or more healthcare data types including claims data, payor revenue/premium data, payor supplemental data, clinical data including clinical quality metrics (HEDIS) and risk adjustment (HCCs), social determinants of health (SDOH), and operational data and KPIs.
?\tProven experience using data and analytics tools. Deep experience using SQL and at least one analytics or visualization tool (PowerBI, Tableau, SigmaComputing, or other).
?\tAbility to communicate analysis to peers and stakeholders.
?\tGenuine curiosity to dive deep into healthcare data and uncover insights and root causes.
?\tDeep commitment to continuous learning as part of a cross-functional team that includes clinical and non-clinical stakeholders.
Preferred Experience:
?\tExperience working in modern data infrastructure (Snowflake or Databricks).
?\tExperience providing analysis and analytics for value-based contracts
?\tExperience working within an agile delivery environment (DevOps)
?\tExperience working with healthcare payors (CMS, regional and national payors)
?\tKnowledge of and experience with healthcare claims data and related claims analytics tools (such as Milliman?s MedInsight, MedeAnalytics, Tuva or claims analytics tools)
?\tKnowledge of and experience with electronic health records (EHRs, such as Epic, Cerner, eCW, Allscripts, Athena)
?\tUnderstanding of clinical workflows and clinical operations as they relate to value-based care and population health
?\tKnowledge of and experience with population health management platforms (such as Epic?s Value Based Care, Innovaccer, Arcadia, Lightbeam or other care management or population health platforms)
LICENSURE/CERTIFICATION/REGISTRY/LISTING:
Equal Opportunity Employer At Cone Health, we strive to create a welcoming atmosphere that celebrates a diverse and unique workforce. We believe in offering equal opportunities for employment to all applicants and employees, regardless of their race, religion, age, sex, sexual orientation, gender identity, veteran's status, ethnicity, national origin, disability, color, or any other characteristic protected by law. Our hiring and employment choices are based on each individual's qualifications, skills and performance. We believe that by embracing the diversity of our team, we can better serve our patients, communities and each other.