Job Details

Value Based Payment Analyst

CareOregon, Portland, Oregon

Job - Non-Profit

Close Date: 06/30/2020

Are you excited to step into a complex world that requires a blend of mind, heart and flexibility? We at CareOregon have been strengthening communities since 1994 by making health care work for everyone. As a nonprofit health plan largely focused on Oregon’s Medicaid population, we find fulfillment in supporting the underserved.

General Statement of Duties
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.
Required Knowledge, Skills and Abilities
• 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
 
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
• Programming with Excel - Advanced Excel

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

Equal opportunity employer. This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

Veterans welcome to apply

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