Senior Director of Value Based Care Analytics & Medical Economics

Cardiovascular Associates of America-posted 3 months ago
Senior
101-250 employees
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The Senior Director of Value Based Care Analytics & Medical Economics leads CVAUSA's analytical capabilities for value-based care contracts, combining hands-on execution with team leadership to deliver critical insights that drive contract performance and strategic decision-making. This high-visibility role works with external payer partners and internal VBC leadership while maintaining deep involvement in complex analytical work. Reporting to the Chief Data Officer, this position focuses on analytical excellence and stakeholder partnership to support CVAUSA's expanding VBC portfolio.

  • Lead opportunity analyses for prospective VBC contracts, including financial modeling, risk assessment, contract structure development, contract evaluation and supporting negotiations with partners
  • Conduct performance analyses of existing VBC contracts across financial, operational, and clinical dimensions
  • Personally execute sophisticated statistical analyses and predictive modeling to support contract optimization and risk management
  • Oversee preparation and validation of medical claims reconciliations with VBC partners
  • Develop and maintain advanced analytical models for contract performance monitoring and forecasting
  • Engage with external actuarial consultant supporting VBC strategy and contracts
  • Manage and develop a team of two analysts: Senior Analyst - Medical Economics and Junior Analyst
  • Provide technical mentorship and guidance on complex analytical challenges
  • Coordinate team capacity and prioritize analytical projects to maximize business impact
  • Foster analytical excellence and ensure quality standards across all team deliverables
  • Balance individual contributor responsibilities with effective team management
  • Serve as primary analytical representative in meetings with payer partners and external stakeholders
  • Present complex analytical findings to diverse audiences, including payer executives and clinical leadership
  • Collaborate with payer data teams on reconciliation processes and performance reporting
  • Support contract negotiations by providing data-driven insights and risk assessments
  • Work closely with VBC leadership including President of VBC and Chief Payer Relations Officer
  • Translate analytical findings into actionable insights for operational and strategic decision-making
  • Support business development efforts through comprehensive opportunity assessments
  • Collaborate with clinical and operations teams to quantify program effectiveness and identify improvement opportunities
  • Provide analytical input to inform VBC strategy development led by the Chief Data Officer
  • Maintain expertise in healthcare claims data, risk adjustment methodologies, and VBC financial models
  • Stay current with industry trends in value-based care analytics and payment model evolution
  • Ensure analytical approaches align with organizational standards while meeting VBC-specific requirements
  • Document methodologies and maintain reproducible analytical processes
  • Contribute to enterprise analytical capabilities through knowledge sharing and best practice development
  • 7+ years of experience in healthcare data and analytics, with minimum 4+ years focused on value-based care, managed care, or health plan analytics
  • Deep experience working with large medical and pharmacy claims datasets, including data normalization, reconciliation, and quality assessment
  • Strong understanding of risk adjustment, IBNR, and other actuarial methodologies applicable to VBC contracts
  • Advanced SQL skills (Snowflake preferred), Python for statistical analysis, Power BI development, and sophisticated Excel modeling
  • 3+ years managing analytical teams with demonstrated ability to develop talent while maintaining hands-on technical contribution
  • Experience with external facing customers in the business development and account management process as the primary analytics representative
  • Master's degree in relevant field preferred
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