Manager, Value Based Analytics

Sanford Health

22h

About The Position

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.
Knowledge of and experience with population health management platforms (such as Epic’s Healthy Planet and Value-Based Performance Management module, TruCare, Innovaccer, Arcadia, Lightbeam or other care management or population health platforms).
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)

Nice To Haves

Master’s degree preferred.

Responsibilities

Provide oversight and expert insight to the analysis of claims, clinical, and operational data to assess performance in value-based contracts.
Ensure success in the reporting and monitoring of key performance indicators (KPIs) such as total cost of care, quality measures, risk scores, utilization, and shared savings metrics.
Recommend and oversee the development, implementation and monitoring of reports and dashboards to track contract performance and identify opportunities for improvement.
Support financial forecasting and impact modeling for value-based contracts and risk-based arrangements.
Contribute to budget planning, performance projections, and shared savings/loss calculations.
Analyze benchmark methodologies, trend factors, and attribution logic to support negotiations and strategy.
Provide analytic support for the design, implementation, and evaluation of new value-based arrangements.
Interpret complex contract terms to translate into measurable analytic goals, as a supporting partner to Network Contract Management
Work with Market Business Partner team across Sanford Health to support value-based care analysis and performance improvement.
Participate in system workstreams providing the analytics and value-based care perspective.
Oversee the development of presentations, executive summaries, and board-level reporting on value-based care contracts, programs and initiatives.
Support team members in their learning and development, with the ability to manage large, complex, simultaneous assignments with potentially conflicting priorities and deadlines.
Work closely across the enterprise with key stakeholders, engage with CMS and national and regional health plans, and regularly present analysis, findings and recommendations to senior leaders.
Other duties as assigned.