| Reporting to the Vice President of Strategic Analytics, the Director of Value-Based Care Analytics will lead strategic value-based care analytics work focused on contract and network performance, cost and utilization analysis, care management , quality and employer reporting. The director will work closely executive level clinical, operational, and financial leadership of the Baylor Scott & White Quality Alliance, the Scott & White Health Plan and Enterprise Analytics. ESSENTIAL FUNCTIONS:
- Consulting to identify non-beneficial clinical variation, reduce waste, and improve the cost-effectiveness and economic efficiency of population utilization, including both medical and pharmacy.
- Lead strategy and execution of direct-to-employer reporting, provider analytics, network, clinical and financial outcomes
- Confidently and knowledgeably present and discuss analysis results, insights, and recommendations to executive level internal and external stakeholders.
- Ensure analytics will support key strategic decisions and incorporate relevant insights and sound data based on robust clinical, quality and business principles.
- Perform trend analysis, predictive analytics, data mining and/or acquire outside research to provide actionable insights that inform strategic and tactical decisions that lead to improved patient and organizational value. Summarize findings and recommend actions.
- Lead the design and development of analytical platforms, tools, and reports designed to understand key business levers to drive customer engagement and usage.
- Oversee processes and architecture for data integrity and forecasting contract financial performance.
- Ensures that data are translated into information that describes accurate and meaningful facts to customers with recommendations for action.
- Collaborate with other analytics leaders and staff to align/further the overall contribution of the VBC Analytics team.
- Work collaboratively with partners to define, develop, and deliver key metrics, dashboards, and related market intelligence programs and solutions across all aspects of population health and value-based care.
- Identify and generate ad-hoc analysis to drive short-term strategies and accelerate change.
- Proactively identify impactful business research. Develop and/or apply business intelligence to drive appropriate action and behavior, measurement and accountability aligned with key business initiatives.
- Performs other position appropriate duties as required in a competent, professional and courteous manner. KNOWLEDGE, SKILLS, and ABILITIES:
- Expertise in medical and pharmacy claims data generation process, metrics, and analysis.
- Expertise in provider data systems, measurement, and analysis including revenue cycle and electronic health records
- Expertise in end-to-end value-based care analytics spanning delivery, quality, medical economics, benefits design, direct to employer and provider network performance
- In-depth knowledge of health care benefits, health plan data science, actuarial and medical economics including reimbursement models
- Exceptional problem-solving skills - both conceptual and analytical
- Strong consulting and influencing skills with a collaborative approach
- Experienced in making professional presentations to senior executives, both clinical and non-clinical, to convey complicated analytical material in a compelling manner
- Work and lead independently yet collaboratively, with multiple functional areas.
- Strong organizational, project management and time management skills
- Ability to translate key learning and insights into actionable business strategies
- Expertise creating data models and finding solutions when the data are ill-formed (incomplete and/or with errors etc. due to issues such as transactional and data management challenges) QUALIFICATIONS:
- Bachelor's degree or equivalent combination of education and experience required
- 5+ Years of experience required |
