[Hiring] Senior Provider Performance Analyst @Amerihealth Caritas

Role Description

The Senior Provider Performance Analyst is responsible for developing, maintaining, and administering provider incentive models.

Work Arrangement:

• Remote - This role may be performed from any location within the United States.
• Availability required during Eastern Standard Time (EST) hours.
• Reliable high-speed internet required (minimum 50 Mbps download / 5 Mbps upload).
• Associates residing in states where reimbursement is required by contract, law, or regulation may submit eligible expenses for reimbursement.

Responsibilities

• Develop, maintain, and execute provider incentive models across the enterprise.
• Ensure the highest levels of data accuracy, integrity, consistency, and completeness across internal and external sources, including Oracle data warehouses.
• Identify data-related issues and perform root cause analyses; collaborate with end-users and IT teams to resolve problems.
• Define and maintain business rules governing the use and interpretation of reporting data fields.
• Identify, validate, and manage data sources to support enterprise reporting needs.
• Create, update, and maintain comprehensive documentation, including data dictionaries, business rules, database structures, and reporting procedures for all lines of business.
• Develop and execute testing processes for data and reporting solutions; track and facilitate resolution of data-related issues.
• Support training and education initiatives related to data comprehension, reporting, and provider performance tracking.
• Assist in the design and refinement of models and metrics that measure provider performance.
• Collaborate with associates across all organizational levels, as well as external clients and vendors.

Qualifications

• Bachelor’s degree in a relevant field required.
• 3 to 5 years of enterprise or business analytics experience within the managed care or healthcare industry required.
• Minimum of 5+ years of experience in data analysis, reporting, or claims processing.

Skills & Abilities

• Strong written communication skills, including experience producing value-based care collateral such as program descriptions, contracting documents, and proposals.
• Demonstrated experience developing value-based programs and provider incentive models, including Episode of Care and Bundled Payment models.
• Solid understanding of statutory reporting requirements.
• Advanced proficiency in Microsoft Office Suite.
• Proficiency in at least one reporting or data analysis tool (e.g., SAS Enterprise Guide, SQL, MS Access).