Senior Population Risk Performance Analyst – Value-Based Care

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🕒 Março 10

🌲 North Carolina – Remoto

🌲 North Carolina – Remote

💵 $98.092 - $156.947 / ano

⏰ Tempo Integral

🟠 Sênior

🎲 Riscos

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E-Verify Program

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

Fundada em 1997

🏛️ Governo

📋 Conformidade

Government • Compliance

O Programa E-Verify é um sistema baseado na web gerido pelo governo dos Estados Unidos que permite aos empregadores inscritos confirmar a elegibilidade de seus funcionários para trabalhar nos Estados Unidos. Gerenciado pelo Departamento de Segurança Interna dos EUA, o E-Verify verifica a identidade e a elegibilidade para o emprego dos funcionários em registros oficiais do governo. Os empregadores podem verificar o status de novas contratações comparando as informações do formulário I-9, Verificação de Elegibilidade para Emprego, com os bancos de dados do Departamento de Segurança Interna e da Administração da Segurança Social.

Descrição

• Apply population risk and actuarial models to normalize performance measurement across value-based care programs • Operationalize CMS-HCC, Milliman, and comparable population risk methodologies for performance evaluation and financial measurement • Support development and maintenance of risk-normalized total cost of care and quality performance metrics • Validate performance measurement methodologies used in shared savings, downside risk, and alternative payment models • Analyze population risk movement and evaluate impacts on program financial performance and provider outcomes • Partner with actuarial and finance teams to align modeling assumptions with contractual measurement logic • Identify and investigate performance variances driven by population acuity, attribution changes, coding variation, or data completeness • Support performance year reconciliation, settlement calculations, and financial exposure analysis • Define and document measurement methodologies, assumptions, and model governance controls • Collaborate with analytics and data engineering teams to integrate risk modeling logic into reporting and measurement pipelines • Provide analytical expertise supporting provider performance reviews and measurement inquiries • Translate complex modeling outcomes into clear insights for operational and executive stakeholders • Ensure consistency and repeatability of population measurement processes across programs and performance periods • Serve as subject matter expert for population risk interpretation supporting value-based care strategy and operations.

🎯 Requisitos

• Bachelor's degree or advanced degree in healthcare administration, business, public health, or related field • 5+ years of experience in related field • In lieu of degree, 7+ years of experience in related field • Demonstrated experience working with population risk models including CMS-HCC and Milliman methodologies (or equivalent) • Experience analyzing healthcare claims and eligibility datasets • Strong SQL and analytical data experience.

🏖️ Benefícios

• Annual Incentive Bonus* • 401(k) with employer match • Paid Time Off (PTO) • Competitive health benefits and wellness programs