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Cone Health · 1 week ago

Lead Analytics Manager - Value Based Care

Greensboro, NC

Full-time

Onsite

Lead/Staff

10+ years exp

Cone Health is seeking a Lead Analytics Manager specializing in Value Based Care. The role involves overseeing data analysis and performance monitoring for value-based contracts, supporting financial forecasting, and collaborating with clinical teams to improve care quality.

Health CareMedicalMedical Device

Responsibilities

Provide oversight and expert insight to the analysis of claims, clinical, and operational data to assess performance in value-based contracts

Ensure success in the reporting and monitoring of key performance indicators (KPIs) such as total cost of care, quality measures, risk scores, utilization, and shared savings metrics

Recommend and oversee the development, implementation and monitoring of reports and dashboards to track contract performance and identify opportunities for improvement

Support financial forecasting and impact modeling for value-based contracts and risk-based arrangements (including CMS and CMMI programs, Medicare Advantage, Medicaid, Commercial, Direct to Employer (D2E), and bundles (including CMS TEAM))

Contribute to budget planning, performance projections, and shared savings/loss calculations

Analyze benchmark methodologies, trend factors, and attribution logic to support negotiations and strategy

Measure and evaluate quality performance against HEDIS, STAR ratings, CMS quality programs, and custom metrics

Collaborate with clinical teams to identify gaps in care and improvement opportunities

Provide analytic support for the design, implementation, and evaluation of new value-based arrangements

Interpret complex payer contract terms to translate into measurable analytic goals

Work with senior leaders across the enterprise and care continuum to support value-based care analysis and performance improvement

Participate in system and network-wide workstreams providing the analytics and value-based care perspective

Oversee the development of presentations, executive summaries, and board-level reporting on value-based care contracts, programs and initiatives

Qualification

Data analyticsSQLHealthcare data analysisPowerBITableauClaims analytics toolsEHR systemsCross-functional collaborationCommunication skillsContinuous learning

Required

Formal training or work experience in data analytics, data analysis, or data science

Minimum of 10 years of experience. 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

Experience working and knowledge of a variety of healthcare data sources 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

Ability to oversee data quality and data integrity and oversee related vendor work

Expert-level experience using data and analytics tools

Deep experience using SQL and at least one analytics or visualization tool (PowerBI, Tableau, SigmaComputing, or other) and working in modern data infrastructure (Snowflake or Databricks)

Experience providing analysis and analytics for value-based contracts including experience working closely with healthcare payors across all lines of business (Medicare, Medicare Advantage, Commercial, Medicaid, Direct to Employer)

Knowledge of and experience with healthcare claims data and related claims analytics tools (such as Milliman's MedInsight, MedeAnalytics, Tuva or claims analytics tools)

Knowledge of and experience with electronic health records (EHRs, such as Epic, Cerner, eCW, Allscripts, Athena)

Understanding of clinical workflows and clinical operations as they relate to value-based care and population health

Ability to communicate complex analysis to non-technical leaders and decision-makers including verbally, in writing, and through effective visualizations

Ability to engage with data engineering and related technical teams to ensure data quality and data integrity

Genuine curiosity to dive deep into healthcare data and uncover insights and root causes

Deep commitment to continuous learning as part of a cross-functional team that includes clinical and non-clinical stakeholders

Preferred

Experience working within an agile delivery environment (DevOps)

Knowledge 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)