PRIMARY FUNCTION
The Manager, Healthcare Analytics will lead the development and delivery of analytics related to membership trends, panel management, quality metrics, cost, and utilization. This role requires a strong balance of analytical expertise and managerial skills, collaborating across key functions—including Clinical, FP&A, Managed Care, and Operations—to translate data into actionable insights. The manager will play a critical role in managing the analysts, driving operational improvements, informing strategic decisions, and evaluating financial outcomes to support enterprise goals.
ESSENTIAL DUTIES AND RESPONSIBILITIES
This list may not include all of the duties that may be assigned.
Manage the Healthcare Analytics team, providing guidance and oversight on data analysis projects, reporting, and business insights development. Gather, process, and validate attributed member, patient, quality metric, cost, and utilization data from multiple sources, including payers and internal Pediatric Associates datasets. Develop and implement analytical methodologies to identify trends, patterns, and opportunities for improvement in VBC attribution, quality, cost and utilization management. Interpret and apply contract language to analytical insights which ensures accurate financial reporting and compliance with payer agreements. Prepare and deliver reports, dashboards, and visual presentations to communicate key findings to leadership and stakeholders. Collaborate with leadership and cross-functional teams to identify business needs, optimize performance metrics, and align analytic strategies with enterprise goals. Prioritize and oversee analytics projects, ensuring timely completion, accuracy, and alignment with organizational objectives. Partner with the data management team to ensure data accessibility, integrity, and alignment with business reporting requirements. Provide mentorship and training to analysts, fostering professional growth and enhancing analytical capabilities within the team.
SUPERVISORY RESPONSIBILITIES
- Manages a team of Analysts.
- Carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws.
- Interviewing, hiring, and training employees.
- Planning, assigning reviewing and directing work, evaluating, and appraising performance.
- Rewarding and disciplining employees, addressing complaints, and resolving problems.
- Make hiring decisions and designs individual development plans with succession planning in mind for all key roles.
QUALIFICATIONS
EDUCATION: Bachelor’s Degree in Statistics, Healthcare Economics, Business, Healthcare Administration, or equivalent combination of education and work experience required.
EXPERIENCE:
- A minimum of 5 years of professional healthcare analytic experience required.
- 7 years of experience in healthcare analytics preferred.
KNOWLEDGE, SKILLS AND ABILITIES
- Strong analytical and problem-solving skills with expertise in data mining, statistical analysis, and data visualization tools.
- Understanding of healthcare terminology and processes.
- Experience integrating clinical data (EMR) with payor data.
- Experience using healthcare eligibility, quality, and claims data sets and how those data sets join.
- Experience reviewing and interpreting contract language and connecting contract language to healthcare data sets.
- Proficiency in data analysis tools (e.g., SQL, SAS, R) and database management systems.
- Ability to manage projects, prioritize tasks, and meet deadlines.
- Understanding business processes and how data can be used to drive decision-making and improve performance.
- Excellent written and verbal communication skills to effectively convey findings and recommendations to both technical and non-technical audiences.
Preferred Knowledge, Skills and Abilities
- Experience in understanding capitation and payer attribution rules
- Experience with quality-based contracts and tracking metric performance
- Experience in Managed Medicaid
TYPICAL WORKING CONDITIONS
- Non-patient facing
- Full time remote
- Job must be U.S. based
OTHER PHYSICAL REQUIREMENTS
- Vision
- Hearing
- Sense of Touch
- Manual Dexterity to operate a computer
PERFORMANCE REQUIREMENTS
Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI (Protected Health Information) in accordance with organizational policy, Federal, State, and local regulations.
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