Sr. Medicare Program Analyst

We’re seeking a Sr. ACO Performance Analytics Analyst to join our Medicare Value-Based Care Programs(VBC) Analytics team. The role’s primary focus is to support our Accountable Care Organizations(ACOs) in the MSSP program. The candidate must have hybrid experience, knowledgeable in both business and technology involving VBC analytics. The Sr. Analyst will closely track performance in the MSSP program based on established Key Performance Indicators(KPIs), communicate performance wins and issues, and provide actionable insights to ACOs that enable data-driven decision making that leads to success in MSSP. Primary Job Duties: Build & Track Key Performance Metrics (KPIs): Track patient attribution, cost, utilization, risk stratification, and quality performance ACO & Provider Performance Tracking: Build actionable analytics for participating Taxpayer Identification Numbers (TINs) and providers that highlight actionable spend anomalies HCC Risk Score Optimization: Evaluate CMS HCC risk adjustment scores to identify performance gaps across the provider network Benchmark & Risk Modeling: Build ad-hoc models to track the ACO’s actual expenditures against CMS-established historical and regional benchmarks CCLF Data Management: Analyze CMS CCLF claims data to monitor total cost of care, out-of-network leakage, and utilization trends Regulatory Changes: Champion understanding of policy and regulations in Value Based Care (VBC) Programs with emphasis in the MSSP Collaborate w