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Cone Health · 2 weeks ago

Value Based Care Analytics Manager Intermediate

Greensboro, NC

Full-time

Onsite

Mid, Senior Level

5+ years exp

Cone Health is seeking a Value-Based Care Analytics Manager, Intermediate who will develop and present advanced analysis for clinical, financial, and operational performance. This role involves analyzing healthcare claims and related data to support value-based care programs and requires collaboration with clinical teams to identify performance gaps and improvement opportunities.

Health CareMedicalMedical Device

Responsibilities

Analyze claims, clinical, and operational data to assess performance in value-based contracts

Monitor key performance indicators (KPIs) such as total cost of care, quality measures, risk scores, utilization, and shared savings metrics

Respond to ad hoc value-based care analytics requests

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

Supports work across a variety of teams and stakeholders

Prepares components for reporting and presentations

Qualification

Data AnalysisSQLHealthcare Claims AnalyticsPowerBIClinical Quality MetricsCross-Functional CollaborationContinuous LearningCommunication Skills

Required

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

Minimum 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

Proven experience using data and analytics tools

Deep experience using SQL and at least one analytics or visualization tool (PowerBI, Tableau, SigmaComputing, or other)

Ability to communicate analysis to peers and stakeholders

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 in modern data infrastructure (Snowflake or Databricks)

Experience providing analysis and analytics for value-based contracts

Experience working within an agile delivery environment (DevOps)

Experience working with healthcare payors (CMS, regional and national payors)

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

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)