Sr. Manager, Medicare Analytics
VillageMD is changing the trajectory of healthcare by empowering primary care physicians to make informed decisions and engage patients in meaningful ways. We work with thousands of clinicians and healthcare disruptors across the country to build and contribute to our platform to improve patient health while driving down the cost to deliver it.
We are a mission-oriented organization and are thrilled about the work that we do every day. We’re transparent, collaborative, and relentless in pursuit of our mission, all while doing so with humility and a low ego. We believe that diverse backgrounds and experiences create the best opportunity for innovation and the community that we are creating is greater than any individual.
We’ve built our technology using the best of cloud and open-source technologies to create an open, data-first platform that is enriched with analytical models and modernly connected to internal and external apps. These apps drive clinical and operational decision support, patient engagement, and other facilitators of innovative, information-enriched health experiences. Our analytics models focus on leveraging the multiple data sources available to us to develop predictive models and algorithms that allow us to deliver meaningful insights that drive improved care for our patients.
As a Sr. Manager, Medicare Analytics you will examine, influence and drive VillageMD’s success in Medicare value-based programs. You will work across our markets to influence operations, product, and policy through innovative and informed analytics models focused on our Medicare contracts. You will also champion the development of a Medicare analytics knowledge base through mentorship and training. The ideal candidate will be someone who is detail oriented and enjoys working in a team-oriented environment that is fast-paced, challenging and provider focused.
What are examples of work that a Sr. Manager, Medicare Analytics will do at VillageMD?
- Conduct analysis, including benchmark and performance forecasts, to inform decisions on value-based participation across our markets
- Facilitate regular deep dive analyses on MSSP performance across markets to influence operational program design, clinical best practices and performance improvement.
- Support teams in developing forecasts and conducting analytics using Medicare HCC models to optimize risk adjustment revenue.
- Participate in cross functional design teams to develop improved analytics, benchmarks, and reporting tools to optimize performance in Medicare value-based programs.
- Assist, train and educate team members on data acquisition, transformation, data reconciliation and presentation related to Medicare performance.
- Review new policies for Medicare value-based programs, synthesize the information, and communicate the implications to our markets and executive leadership
What will make you successful here?
- Strong attention to detail
- Strong analytical, problem-solving, and technical skills
- Ability to consult with clients to understand business problems, elicit business requirements, develop analysis roadmap, and deliver results according to project plan.
- Be able to explain complex logic and technical topics in a clear, concise manner
- Experience with SQL, R or other open source analytical tools
- Experience with Tableau is a plus
- The ability to handle multiple, concurrent projects
- Challenging the status quo to improve our processes and tools
- A low ego and humility; an ability to gain trust by doing what you say you will do
The following experience is relevant to us:
- A bachelor's degree and a minimum of 8 years’ relevant experience in Federal Government and large health plan organizations; big consulting firm experience; an advanced degree preferred.
- BS/MS in a quantitative field such as computer science, math, engineering, or other related fields is required.
- Expertise on Centers for Medicare and Medicaid (CMS) policy guidance and approval process.
- Experience working with Medicare fee-for-service and managed care operations, appeal and grievances, payment processes and performance incentives.
- Experience working with Medicare data sets, especially claims, revenue, and encounters data. Experience with quality measures and ratings is a plus.
- A track record of working independently to lead large complex projects according to the scope, work plan, quality standards and budget.
- Strong oral and written communication skills, including executive leadership presentation skills
- Strong problem solving and troubleshooting skills with the ability to exercise mature judgment.
At VillageMD, we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.