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Senior Analyst (Payer Analytics)
Population Health
Remote - US
Full Time

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Title/Position: Senior Analyst (MA Payer Analytics)

Department or Business Unit: Business Analytics

Employment Type: FTE

Exemption Status: Exempt

Min. Experience: Mid-Level

Travel Required: No

Overview of the Role:

The Senior Analyst (MA Payer Analytics) will work cross functionally within the team, helping develop a purpose-driven analytics platform to maximize the health of our patients and the performance of our physicians using proprietary applications. Primary emphasis for this role will be analysis of Privia’s performance in Medicare Advantage Programs. You will work with a cross-functional team composed of Population Health Market Leadership, IT , Quality, Risk Adjustment, and Operations to understand evolving requirements and business needs to build reports using payer and internal data. You will also execute business and payer-facing ad hoc analyses, using data to guide strategic discussions among and between internal and external stakeholders.

Primary Job Duties: 

  • Champion understanding of Medicare Advantage Programs with emphasis in STARs and Documentation & Coding performance in Medicare Advantage Programs
    • Calculate key performance metrics and apply data mining techniques to identify opportunities for improvement
    • Apply data mining techniques to STARs, HCC, Total Cost of Care Performance and opportunities for improvement
    • Understand patient attribution
  • Clinical Analytics
    • Assist in reporting quality and utilization measures performance
    • Assist in identifying opportunities for performance improvement within MA Programs and developing the provider facing materials to support change
    • Leverage clinical data to identify opportunities to close care gaps
    • Leverage payer reports to develop provider level reporting to improve performance
    • Build physician profiles to identify performance outliers
    • Perform analysis to understand utilization patterns
  • Data Intelligence
    • Collaborate closely with IT leadership, engineers and 3rd parties to enhance our SQL data platform, semantic layers, and BI tool (MicroStrategy) to enable scalable, multi-market content distribution 
    • Become a data SME on data from MA Payers, EMRs, ADTs, and other vendors
  • Work closely with the Population Health, Quality, and Risk Adjustment team to understand their evolving information needs, and plan and execute on analytics strategies and solutions that are in alignment with those needs. 
  • Assist in the development of key performance indicators (KPIs), and develop a corresponding suite of reports and dashboards that help functional heads understand and impact performance over time
  • Produce ad-hoc reporting and perform other duties as assigned

Minimum Qualifications:

  • 2-5 years of professional experience 
  • Bachelor’s Degree, preferably quantitative major (e.g. engineering, analytics,, applied math, statistics, etc) 
  • Strong experience with SQL required. Experience with data mining software (R, SAS, Python) highly desirable 
  • Experience integrating, manipulating, transforming data (claims, EMR, ADT, Rx labs, etc. ) 
  • Understand basic business concepts related healthcare claims/insurance and/or physician group dynamics 
  • Experience working at a health plan, hospital system, ACO, provider organization, consulting firm, technology start-up, or previous healthcare analytics experience and capabilities
  • Must comply with HIPAA rules and regulations 

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; talk or hear.


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