Job Details

Value Based Payment Analyst

CareOregon, portland oregon

Job - Health

Close Date: 05/25/2020

This position leads the analysis of health outcomes, quality of care, financial analysis, and health care utilization studies in relation to Value Based Payment (VBP) models. This includes performing statistical analysis using analytical tools, assisting in developing long-term plans that will meet the analytical needs of the organization, and assisting leadership in interpreting various provider opportunities and proposals. This position is the primary liaison with external and internal actuaries, as well as Network and Clinical Support (NCS) staff supporting our provider network.

Essential Position Functions
Participate in the creation of NCS analytical plans and VBP proposals.
Provide leadership in development, analysis and ongoing monitoring of VBPs, including risk agreements, capitated payments, Primary Care, Behavioral Health, and Specialty innovative payments programs, Durable Medical Equipment (DME), Implant, and Pharmaceutical VBPs, and other programs.
Act as “data translator” between the actuarial/finance language to network appropriate presentations.
Develop and present educational, training and program materials on VBPs for NCS teams and Network partners.
Using in-depth knowledge of the financial dynamics of the health-care industry, advise management relative to cost and utilization outcomes from different payment scenarios.
Analyze administrative and clinical data, and assess its quality, validity and reliability.
Use appropriate software tools to retrieve, edit and tabulate data from various databases and files.
Study and analyze tables, graphs, charts and other statistics and report results in a variety of formats.
Write reports, as needed, such as statistical studies, narrative reports, articles for publication; develop report summaries by explaining the significance of trends.
Develop dashboards, scorecards, and other tools using data visualization tools such as Excel.
Develop algorithms, models and repeatable analytics tools to mature use and creation of data products at Care Oregon.
Create and maintain technical documentation such as data dictionaries, business glossaries, metric definitions and other data resources to support the ongoing operations of VBPs.
Effectively collaborate with other teams within organization to develop strong data pipelines and reusable data products.
Remain current with technology and analytical methods.
Contribute and actively participate in community of practice to improve skills and capabilities of all Analysts at Care Oregon.


Essential Department and Organizational Functions
Propose and implement process improvements.
Meet deadlines for completion of workload.
Maintain agreed upon work schedule.
Demonstrate cooperation and teamwork.
Provide cross-training on specific job responsibilities.
Mentor other team members to help improve skills and knowledge of others in the organization.
Meet identified business goals that contribute to departmental goals.
Perform other duties as assigned.


Required Knowledge, Skills and Abilities
Excellent critical thinking and problem-solving skills
Knowledge of healthcare payment models and evolving changes in the healthcare payment space
Advanced skills in Excel, preferably with VBP
Report writing abilities, including advanced queries for data manipulation
Ability to independently gather, compile and analyze data and prepare narrative and statistical reports
Willingness to learn and apply new skills
Strong written and verbal communication skills
Ability to effectively present and convey complex information to internal and external stakeholders
Ability to work in an environment with diverse individuals and groups
Ability to manage multiple tasks


Preferred Knowledge, Skills and Abilities
Knowledge of Tableau Desktop/Creator
Knowledge of Managed Care
Knowledge of Medicaid and/or Medicare programs
Knowledge of financial matters in the healthcare industry
Knowledge of medical, behavioral health and/or pharmacy claims
Skills with statistical software packages helpful, such as Python, R or SAS
Ability to provide leadership and oversight of research and analytical projects

Education and/or Experience

Required:

Minimum 5 years’ related experience required, including the following:
Writing advanced queries for data manipulation
1 year of experience in a healthcare data domain (e.g., Claims, Pharmacy, Clinical, Dental, etc.)
Preferred:

Analytical experience relating to VBP models
Experience with statistical software packages, such as Python, R or SAS
Master’s or Bachelor’s degree in STEM, Finance, Economics, Business Administration, Public Health, Management Information Systems, Computer Science, or related degree helpful

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