Job Requirements Serves as a strategic partner to Population Health, Quality, Operational, and Business leaders to advance value-based care performance, improve patient outcomes, and support organizational financial success. Functions as a subject matter expert in population health analytics, quality improvement, and value-based care, leveraging advanced analytical methods to identify trends, performance gaps, and opportunities for improvement. Translates complex clinical, operational, financial, and quality data into actionable insights, dashboards, and reporting solutions that inform decision-making and drive organizational priorities. Leads and supports cross-functional initiatives focused on quality performance, regulatory compliance, payer program optimization, and shared savings achievement. Evaluates the impact of clinical programs and interventions, provides strategic recommendations, and collaborates with stakeholders across clinical, operational, financial, and technical teams to enhance performance and support continuous improvement.
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job responsibilities performed.
- Serves as a subject matter expert in value-based care, population health analytics, and quality improvement, identifying trends, performance gaps, risks, and opportunities to improve outcomes and financial performance.
- Analyzes and monitors performance across quality measures, health outcomes, patient experience, utilization, and operational indicators to support value-based care initiatives and organizational goals.
- Develops, manages, and maintains quality roadmaps, performance dashboards, scorecards, and improvement plans to track progress and drive accountability.
- Provides advanced analytical and consultative support for population health, quality, and value-based care programs, translating complex data into actionable insights and strategic recommendations.
- Partners with clinical, operational, and business stakeholders to develop, implement, and evaluate quality
improvement initiatives and population health strategies.
- Leads or supports projects designed to improve value-based care performance, quality outcomes, reporting capabilities, and shared savings opportunities.
- Collaborates with cross-functional teams, including Practice Transformation, Risk Adjustment, Care Management, and Payer Relations, to ensure alignment of data, reporting, and strategic priorities.
- Designs and consults on automated, scalable reporting solutions, dashboards, and performance monitoring tools that support clinical operations, regulatory compliance, and organizational objectives.
- Translates clinical, business, operational, and regulatory requirements into practical analytics and reporting solutions that inform decision-making and support performance improvement efforts.
- Evaluates the effectiveness of clinical programs, interventions, and operational initiatives through performance measurement, impact analysis, and return on investment (ROI) assessments.
- Communicates findings and recommendations effectively to technical and non-technical audiences, enabling informed decision-making and action.
- Represents the department on medium- to large-scale projects and serves as a liaison between business, clinical, operational, and technical stakeholders.
- Supports knowledge sharing, onboarding, and mentoring activities to promote team effectiveness and professional development.
- Maintains knowledge of emerging trends, payer requirements, quality programs, and best practices related to population health and value-based care.
- Perform all other duties as assigned.
Work Experience - Master's degree in Health Informatics, Public Health, Healthcare Administration, Data Science, or a related field; or an equivalent combination of education, training, and experience.
- Seven (7) years of experience in healthcare analytics, population health, quality improvement, value-based care, or a related field.
- Seven (7) year previous experience working with healthcare data, including claims, clinical, quality, and population health data across Medicare, Medicaid, and Commercial payers.
- Seven (7) years' experience supporting quality reporting and value-based care programs, including regulatory and accreditation requirements.
- Five (5) years' experience analyzing large, complex datasets and developing reports, dashboards, and actionable insights to support decision-making and performance improvement.
- Previous experience with electronic health record systems, preferably Epic, and healthcare analytics and reporting tools, and collaboration tools (such as SharePoint, Confluence, or similar platforms).
