Value Based Payor Performance Analyst, Full Time, First Shift

Under minimal supervision, the analyst interpreates payer performance methodologies and contractual requirements; validates and reconciles payer-reported quality, utilization, attribution, and financial results; and forecasts incentive attainment, shared savings, and revenue at risk. This role serves as a key analytical liaison between Managed Care, Finance, Population Health, Quality, operational leaders, and payer partners.

Responsibilities

• Monitors the performance of assigned value-based care contracts, including quality, utilization, patient attribution, and financial results.
• Tracks contract requirements, incentive opportunities, shared savings, and potential financial risks.
• Analyzes and forecasts contract performance, identifying trends, risks, and opportunities for improvement.
• Reviews payer calculations and compares them with UC Health's data to ensure accuracy.
• Prepares, validates, and submits required quality reports, scorecards, and supporting documentation to payers and regulatory programs.
• Interprets quality measure requirements, reporting guidelines, and contract provisions to ensure compliance.
• Maintains reporting schedules, documentation, and audit-ready records.
• Serves as a key contact for payer questions related to quality reporting and performance results.
• Monitors reporting deadlines, performance obligations, and compliance requirements for value-based care programs.
• Identifies reporting issues, compliance risks, and performance concerns, escalating significant issues to leadership.
• Tracks changes in payer and regulatory requirements and evaluates their impact on operations and financial performance.
• Reconciles payer performance reports with internal data, investigating and resolving discrepancies.
• Collaborates with Managed Care leadership and payers to address data, quality, attribution, and reimbursement issues.
• Tracks disputed items through resolution and quantifies the financial impact of variances.
• Develops performance dashboards, scorecards, and executive reports that summarize quality, utilization, financial results, and compliance status.
• Provides leadership with insights on performance drivers, risks, and opportunities to improve contract outcomes.

Requirements

• Bachelor's Degree.
• 3-5 years equivalent experience in value-based contracting, payor performance, healthcare finance, managed care analytics, quality reporting, or healthcare reimbursement.

Location: Cincinnati, OH, United States