Manager, Value Based Analytics

The Manager, Value Based Analytics will develop and lead presentation of advanced analysis of clinical, financial and operational performance leveraging healthcare claims, clinical, operational and additional relevant data sources. This role will inform strategic decision-making and action planning across Sanford Health Plan and Sanford Health regarding value-based care and risk-based programs.

Requirements

• Bachelor’s degree in Healthcare Administration, Finance, Economics, Data Analytics, Actuarial Science, Data Science, Information Technology or related field required.
• Seven (7) years of related experience required.
• Must possess previous supervisory and/or consulting experience.
• Requires expert knowledge of healthcare claims and claims analytics, clinical quality and quality metrics, clinical coding, care team operations and initiatives as well as analytics tools and techniques for the analysis of this data.
• Experience working and knowledge of a variety of healthcare data sources including claims data, payor revenue/premium data, payor supplemental data, clinical data including clinical quality metrics (HEDIS) and risk adjustment (HCCs), social determinants of health (SDOH), and operational data and KPIs.
• Expert-level experience using data and analytics tools.
• Deep experience using SQL or analytics or visualization tools (such as Power BI or Tableau)
• Experience providing analysis and analytics for value-based contracts including experience across all lines of business (ACA, Medicare, Medicare Advantage, Commercial Group, and Medicaid)
• Knowledge of and experience with healthcare claims data and related claims analytics tools (such as Milliman MedInsight)
• Knowledge of and experience with electronic health records (such as Epic, Cerner)