Note: The job is a remote job and is open to candidates in USA. Privia Health is seeking a Sr. ACO Performance Analytics Analyst to support its Accountable Care Organizations in the Medicare Shared Savings Program. The role tracks performance metrics, analyzes claims and risk data, and provides actionable insights to support data-driven decisions and program success.
Responsibilities
- Build & Track Key Performance Metrics (KPIs): Track patient attribution, cost, utilization, risk stratification, and quality performance
- ACO & Provider Performance Tracking: Build actionable analytics for participating Taxpayer Identification Numbers (TINs) and providers that highlight actionable spend anomalies
- HCC Risk Score Optimization: Evaluate CMS HCC risk adjustment scores to identify performance gaps across the provider network
- Benchmark & Risk Modeling: Build ad-hoc models to track the ACO’s actual expenditures against CMS-established historical and regional benchmarks
- CCLF Data Management: Analyze CMS CCLF claims data to monitor total cost of care, out-of-network leakage, and utilization trends
- Regulatory Changes: Champion understanding of policy and regulations in Value Based Care (VBC) Programs with emphasis in the MSSP
- Collaborate with IT, ACO leaders, and Operations teams to help ensure Privia Health’s success in the MSSP program
Skills
- 2+ years of professional experience
- Intermediate level experience with SQL and SAS
- Ability to communicate complex assessments and insights derived from data, CMS guidelines, ACOs' performance indicators, regional, and national healthcare trends to a variety of audiences
- Ability to distill analytical findings into clear insights and action steps
- Ability to translate complex business problems to technical requirements and design solutions
- Ability to remain flexible with changing priorities
- Relationship builder
- Critical thinker
- Proactive and self-motivated
- Bachelor's Degree preferred
- Healthcare (e.g. public health) or quantitative major (e.g. engineering, analytics, economics, actuarial sciences, statistics)
- Experience in healthcare claims data, EMR, hospital admission and discharge data, healthcare codes (CPT/HCPCS/provider specialty, diagnosis, place of service, revenue), healthcare claims adjudication (claim payments, adjustment/reversals, denials), healthcare claims processing preferred
- Snowflake experience preferred
Benefits
- Medical, dental, vision, life, and pet insurance
- 401K
- Paid time off
- Other wellness programs
- An annual bonus targeted at 15%
- Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
- Remote work
Company Overview
- Privia Health is a physician enablement company that provides technology and services to optimize the healthcare delivery experience. It was founded in 2007, and is headquartered in Arlington, Virginia, USA, with a workforce of 501-1000 employees. Its website is http://www.priviahealth.com.
