Sr. Manager, Value Based Payments & Cost Transparency Analytics

Your Role 

The Data & Analytics (D&A) team focuses enterprise-wide to partner with business stakeholders to apply the power of data & analytics to deliver new insights and data-driven solutions to accelerate business outcomes.  Reporting to the Senior Director of Care Delivery Analytics, the Senior Manager of Value Based Payments & Cost Transparency Analytics is responsible for working with the key stakeholders from Finance, Actuary, Health Solutions, Product Management and others to be the Data & Analytics partner in accelerating achieving business objectives.  This critical analytics team collaborates with other analytical and business teams and delivers analytical insights to power the business forward.  This role requires not only analytical prowess but also a broad understanding of the business and business levers that matter.   Being able to act as "two-in-a-box" partner with business stakeholders is critical.  You will be setting direction, managing against multiple competing deadlines, and driving change management. 

This role must be adept at "translating" the business problem into an analytical approach, driving the team of analytics professionals, and bringing in other specialties from within the D&A team such as data engineering, visualization, predictive modeling, and data governance as appropriate.  The Senior Manager leads a team of analysts, has an in-depth understanding of how information is consumed, and how analytics support these key business functions in the organization.  Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building, and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work 

In this role, you will:

• Partner with Actuary and Network Management to understand parameters needed to perform multiple attribution models.
• Build and deliver monthly retrospective and prospective attribution datasets.
• Adjust monthly attribution file based on inter-plan feedback from other Blues entities.
• Perform validation of monthly runs and partner with Actuary on any root cause analysis and remediation of errors
• Implement data quality rules necessary to ensure timely and accurate delivery.
• Deliver custom reports to provider entities.
• Deliver monthly utilization and annual benchmarking of ACO programs. 
• Analyze and implement operational frameworks and develop analytical product components to support the commercial product lifecycle.
• Lead our payment transformation analytics and make recommendations on new payment models focused on affordability and quality.
• Partner internally for timely submissions to the National Cost Transparency program for the Blues Association
• Develop insights stemming from the machine-readable-files (MRFs) in compliance with the Transparency in Coverage federal mandate.
• Adjust to changing regulatory requirements.

Your Knowledge and Experience

• Bachelor's degree with 10+ years of data/analytics experience; healthcare payment model based experience a plus.
• 4+ years of people management experience
• Strategic, but able to be hands-on if needed; familiarity with SQL, Python, SAS, Tableau, etc. helpful.
• Understanding of the payor-provider landscape and keeps abreast of industry trends and innovations in payment approaches.
• Experience in translating business problems into analytical approaches, driving solutions, partnering to implement change, and measuring outcomes.
• Experience in partnering with business stakeholders to drive to business outcomes through analytics.
• Clear communicator and influencer that can operate at multiple levels from analyst to executive.
• Experience building, engaging, and retaining high performing teams
• Detailed oriented; is proud of his or her end products.
• Has grit; energized by challenges.
• Excited by the prospects of using data & analytics to improve the lives of people.