Director – Population Health Analytics

Director – Population Health Analytics

Requirements

• Bachelor’s Degree in Statistics, Finance, Computer Science, Information Systems, Mathematics, Engineering, Actuarial Sciences, Economic Sciences or related field highly preferred OR equivalent relevant experience
• Advanced degree in Engineering, Statistics, Mathematics, Economics, FSA, or a PhD in a health related field or actuarial designation preferred
• Excellent communication skills (verbal, written, and presentation) to effectively interact with various stakeholders, including senior leadership, providers, and team members
• Strong collaboration and interpersonal skills to work effectively across different departments and with external partners
• Technical, analytical and financial experience in the subject area of healthcare claims, EHR data, tools, and systems
• Knowledge of healthcare operations, including areas like medical management, claims, and provider networks
• Minimum of 8 years’ experience working in a high functioning analytics/informatics team combined with experience in analytics languages and platforms
• Proven experience improving the efficiency and automation of an analytics function and its effect on organizational performance
• Advanced understanding Risk Adjustment modeling and implementation
• Strong proficiency in statistical analysis, data mining, and the use of analytical tools and software (e.g., SQL, SAS, Python)
• Strategic thinking with the ability to develop and implement strategies to achieve desired outcomes
• Regulatory Compliance: Stay abreast of changes in risk adjustment regulations (e.g., CMS, HHS) and ensure analytical processes and reporting are compliant
• Must comply with HIPAA rules and regulations

Responsibilities

• Champion all aspects of measurement of Population Health Performance Deals, from deal structure and measurement, to construction of KPIs and analytical measures
• Design, build and maintain complex models supporting population health dynamics incorporating ‘what-if’ analytics for scenario planning
• Build upon and maintain robust Risk Adjustment modeling and analytics across our Value Based Care (VBC) arrangements
• Build models to prospectively measure performance and total cost of care for VBC deals, estimating performance and run-rate scenarios
• Perform gap and outliers analysis on focus areas of medical economics and VBC deals
• Design and execute KPIs to track performance and take accountability for accurately communicating to extended teams
• Key liaison between the Medical Economics team and Privia stakeholders to communicate key findings and opportunities in Population Health space
• Deep understanding of risk adjustment methodologies, including Hierarchical Condition Categories (HCCs)
• Communication and Presentation: Effectively communicate complex analytical findings and recommendations to various stakeholders, including senior leadership, through clear presentations and reports
• Other duties as assigned

Preferred Qualifications

• Advanced degree in Engineering, Statistics, Mathematics, Economics, FSA, or a PhD in a health related field or actuarial designation preferred