Healthcare Analyst

Role Overview

This position involves leading clinical and health economics analytics to evaluate patient risk, outcomes, and cost efficiency in family-led home care.

Key Responsibilities

• Develop risk models, risk adjustment methodologies, and analyze claims data to inform care prioritization and validate risk models.
• Lead cost of care and ROI analyses to quantify the value of family-led care for payors and government partners.
• Design clinical studies to research health outcomes such as readmission rates and quality of life, ensuring rigorous methodology and industry standards.
• Generate evidence through publications, white papers, and conference presentations to establish credibility.
• Collaborate with cross-functional teams including Clinical, Finance, Engineering, and Product to define metrics, data models, and measurement frameworks.

Qualifications & Skills

• 5+ years in healthcare analytics, health economics, outcomes research, or population health.
• Proficiency in SQL, Python or R, with experience analyzing payor claims data and familiarity with coding standards.
• Experience working with health plans, payors, or actuaries, and designing health outcomes studies.
• Strong communication skills to translate complex data into actionable insights for diverse stakeholders.
• High standards for data quality, documentation, and analytical rigor.

Preferred Experience

• Background in value-based care, risk-bearing healthcare organizations, or population health.
• Knowledge of Medicaid, Medicare, and clinical risk modeling techniques.
• Experience with AI systems, prior authorization, and revenue cycle data.

Summary

This role requires a strategic and analytical healthcare professional capable of developing risk and outcomes models, analyzing costs, and generating evidence to support family-led care initiatives. The ideal candidate excels in cross-functional collaboration, has a deep understanding of clinical and economic metrics, and is committed to advancing innovative care solutions.