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Sr. Associate II, Provider Analytics
Boston, MA
Job Description
Why This Role is Important to Us:
What You'll Be Doing:
What We're Looking For:
Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
Position Summary:
As a Sr. Associate II specializing in Network Analytics, Network Finance, and Value-Based Care (VBC) Contracting, this position play a pivotal role in shaping our network strategy, optimizing financial performance, and driving value-based care initiatives. This position will collaborate with cross-functional teams to analyze network data, assess financial implications, and negotiate contracts with healthcare providers aligned with our value-based care objectives.
As a Sr. Associate II specializing in Network Analytics, Network Finance, and Value-Based Care (VBC) Contracting, this position play a pivotal role in shaping our network strategy, optimizing financial performance, and driving value-based care initiatives. This position will collaborate with cross-functional teams to analyze network data, assess financial implications, and negotiate contracts with healthcare providers aligned with our value-based care objectives.
Supervision Exercised:
No, this position does not have direct reports. No direct supervision, but mentorship of junior analysts while performing in a consultative capacity is essential.
No, this position does not have direct reports. No direct supervision, but mentorship of junior analysts while performing in a consultative capacity is essential.
What You'll Be Doing:
Essential Duties & Responsibilities:
Network Analytics:
- Utilize advanced analytical tools and techniques to assess network performance, including provider utilization, cost trends, and quality metrics.
- Develop and maintain dashboards and reports to track key performance indicators (KPIs) related to network efficiency, patient outcomes, and financial performance.
- Conduct deep-dive analyses to identify opportunities for network optimization and improvement, leveraging data-driven insights to inform strategic decision-making.
- Coordinate with cross functional teams, including Business Intelligence, IT, Operations,
- Clinical and Medical Management
- Mentor junior analysts
Network Finance:
- Collaborate with finance teams to develop budgets, forecasts, and financial models related to network contracting and reimbursement.
- Monitor financial performance of contracted providers, analyze variances, and recommend corrective actions to ensure alignment with financial targets.
- Assess the financial impact of network contracting decisions, including fee schedules, reimbursement methodologies, and value-based incentives.
Value-Based Care (VBC) Contracting:
- Lead negotiations with healthcare providers to establish value-based care contracts, focusing on quality, outcomes, and cost-effectiveness.
- Develop innovative payment models and incentive structures to promote value-based care delivery and reward providers for delivering high-quality, efficient care.
- Collaborate with internal stakeholders and external partners to implement and monitor value-based care initiatives, ensuring alignment with organizational goals and objectives.
Working Conditions:
- Standard office conditions.
- Remote
What We're Looking For:
Required Education (must have):
- BA/BS in Mathematics, Economics, Healthcare Administration, Business, Finance, or related field
Desired Education (nice to have):
- Master's degree (MPH, MPA, etc) preferred
Required Experience (must have):
- Minimum of 5 years of experience in healthcare analytics, network management, or related field, with a focus on network finance and value-based care contracting.
- Proficiency in data analysis and visualization tools such as SQL, Python, R, Tableau, or Power BI.
- Strong understanding of healthcare reimbursement methodologies, including fee-for-service, capitation, bundled payments, and value-based incentives.
- Excellent negotiation skills and ability to build strong relationships with healthcare providers and external partners.
- Proven track record of driving results in a fast-paced, dynamic environment, with a focus on delivering actionable insights and driving continuous improvement.
- Experience working with Excel with large datasets, VLOOKUP, pivot tables, and advanced functions/formulae.
Required Knowledge, Skills & Abilities (must have):
- Strong organizational, analytic, and problem-solving skills
- Independent and self-motivated candidate who can drive a project from beginning to end
- Basic understanding of Medicare and Medicaid programs
- Interpersonal communication skills enabling the incumbent to collaborate effectively within department and across functions.
Required Language (must have):
- English
Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
5+ years
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