This role requires to be onsite approximately 1-2 days per month, however, additional in-office presence may be needed based on business priorities.
The Business Analyst, Value-Based Care, supports the financial operations performance analytics, and cost of care monitoring of value-based care programs and payer contracts. This role is responsible for processing reimbursements, tracking contract payments, maintaining financial performance models, supporting budget activities, and providing routine financial analysis related to value-based care initiatives. The analyst will work closely with operational, clinical, finance, and contracting teams to ensure accurate payment reconciliation, reporting, and identification of financial opportunities within value-based arrangements.
Essential Functions of the Job: This position serves as a key administrative and financial resource for the Value-Based Care team, supporting contract performance monitoring, shared savings analysis, risk adjustment initiatives, and financial optimization efforts.
Financial Operations and Payment Management- Process value-based care reimbursements and incentive payments received from payer partners and support validation of payer performance reports.
- Track payment status, reconcile payment reports, and investigate discrepancies.
- Coordinate allocation and distribution of funds across departments, providers, and applicable cost centers.
- Maintain documentation supporting payment calculations, distributions, and audit requirements.
- Assist with monthly and annual financial close activities related to value-based care programs.
Budget and Financial Reporting- Support development and monitoring of department budget.
- Prepare recurring financial reports and summaries for leadership review.
- Maintain and update value-based care financial optimization models.
- Summarize and monitor profit and loss (P&L) performance across value-based care contracts and programs.
- Assist with forecasting revenue, incentive payments, and contract performance trends.
Value-Based Care Analytics- Monitor financial performance of value-based care contracts, including shared savings, quality incentives, care management fees, and risk-adjusted payments.
- Analyze payer reports and performance data to identify opportunities for revenue optimization and operational improvement.
- Support risk adjustment initiatives through financial analysis and reporting.
- Conduct spend and utilization analyses to identify cost-saving opportunities and areas of financial risk.
- Develop reports, dashboards, and presentations to communicate financial performance to leadership.
Collaboration and Program Support- Attend value-based care meetings, payer meetings, and operational workgroups to support program initiatives and gain knowledge of emerging opportunities.
- Collaborate with finance, contracting, quality, population health, and operational teams to support contract performance.
- Assist with special projects related to value-based care strategy, shared savings opportunities, and financial optimization.
- Support preparation of materials for leadership meetings, payer discussions, and financial reviews.
Position Compensation Range: The pay range for this role is $70,595.20 - $112,944.00 annually. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.
REQUIRED QUALIFICATIONS (Knowledge, Skills & Abilities) :Education:
- Bachelor's Degree in Finance, Accounting, Business Administration, Healthcare Administration, Economics, or a related field required.
Experience:
- Minimum of 3 years of experience in financial analysis, healthcare finance, accounting, reimbursement, revenue cycle, managed care, or a related analytical role.
- Experience working with budgets, financial reporting, payment reconciliation, or healthcare reimbursement.
- Experience supporting value-based care, managed care contracts, or healthcare operations preferred.
- Experience analyzing healthcare claims, utilization, cost-of-care, or population health performance data preferred.
Knowledge and skills:
- Strong financial acumen and analytical skills.
- Advanced Microsoft Excel skills, including pivot tables, formulas, lookups, and financial modeling.
- Ability to analyze financial data and translate findings into actionable recommendations.
- Strong attention to detail with excellent organizational and documentation skills.
- Effective verbal and written communication skills.
- Ability to work collaboratively with clinical, operational, and financial stakeholders.
- Experience with reporting tools, databases, Tableau, Power BI, SQL, or similar platforms preferred.
- Knowledge of healthcare reimbursement, value-based care programs, risk adjustment, and shared savings methodologies preferred.
- Knowledge of attribution methodologies, risk adjustment, HCC coding, shared savings/loss calculations, and value-based reimbursement models preferred
SUPERVISORY RESPONSIBILITIES : No WORKING CONDITIONS : This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally require traveling some distance to attend meetings, and programs.
