Senior Accountable Care Organization (ACO) Analyst

PURPOSE OF POSITION :

Develops metrics and reports in support of Cape Cod Healthcare Accountable Care Organization (“CCHCACO”) value-based contracting and population health initiatives.

PRIMARY DUTIES AND RESPONSIBILITIES :

• Develops and maintains data sets to enable advanced reporting on several aspects of value-based care performance related to CCHCACO covered lives, including cost and utilization, quality, and ambulatory care management.
• Supports CCHCACO case management, quality, payer enrollment and risk coding teams with performance reports and actionable insights, including provider-level reports.
• Maintains department operational and performance dashboards and related supporting documentation.
• Identifies and reports on trends or patterns within administrative claims or EMR data sets; performs risk stratification analysis identifying illness burden and high-risk patients.
• Extracts, transforms and loads administrative claims and electronic medical record (“EMR”) data via flat file or query via application programming interface (“API”)
• Utilizes CCHC Epic and other EMRs (e.g., Athena, eClinicalWorks) to extract information relevant to analyses and validate EMR data findings.
• Supports clinical data exchange with payers and in support of contract performance or maintenance of the provider network.
• Assist CCHCACO and CCHC leadership with development of analyses of contract proposals, fee schedules, charge-master changes and contract performance for CCHCACO and CCHC.
• Utilizes good data governance standards when bringing together differing data sets by documenting assumptions, sources, methods and validating control totals.
• In coordination with ACO staff, analyze data to view population health trends and patterns; identify individual health risks and high-risk populations; find opportunities to improve care at the population and individual level.
• In coordination with ACO staff, develops credible metrics and internal / external benchmarks in order to measure ACO performance against “goal.”

EDUCATION / EXPERIENCE / TRAINING :