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Senior Provider Performance Analyst

Location
Billerica, Massachusetts
Job Type
Permanent
Posted
1 Sep 2022

The core business model of Tufts Health Public Plan's products features multiple strategic provider partnerships including partnership with provider accountable care organizations (MassHealth ACOs). The senior analyst of accountable care strategy and business performance assumes ownership in the planning, development, management and continuous improvement of provider performance, with the goal of achieving overall program success as measured by P&L performance, growth, innovation, quality outcomes, and compliance, etc. Key success factors of the role include strategic and analytical problem solving, strong business leadership and execution, and effective collaboration with internal and external stakeholders.

This position reports to the Director of Strategy and Business Performance

Job Description

KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS:
A principal measurement of ACO success is its performance against defined total cost of care and quality targets. As such, an essential responsibility of THPP via the partnership is to support ACOs' performance improvement efforts:

The senior analyst will develop a deep understanding of each ACO's performance against defined targets, which include cost, utilization, quality and other key indicators.

  • Working closely with THP enterprise functions that produces data-driven reports, proactively identify needed analytics to understand performance drivers and develop actionable insights.
  • Develop line of business specific detail data driven information solutions to facilitate provider performance improvement initiative design.
  • Working with clinical programs such as population health management and utilization management, identify and develop strategic initiatives that capitalize on prioritized opportunities.
  • In alignment with the broad strategic plan, collaborate with provider partners and internal departments to act on identified performance improvement opportunities.

As the THPP point of person for Provider Performance, the senior analyst will:

  • Research, analyze, and interpret data for provider performance improvement activities through programming and statistical model building.
  • Present analytical findings to both internal and external stakeholders including clinicians.
  • Respond to Provider Performance related issues that come up from the provider partners, assess the issues and appropriately either triage them to the right departments for resolution or work with the Product team to resolve them. See to it that the issues are resolved or otherwise escalated as needed. Maintain coordination and communication throughout the process.
  • Build and maintain strong and trusting relationships with both provider partners and internal stakeholders

The provider partnership is a structure where THPP and its provider partners collaborate in the development of new programs and solutions, which lead to long-term improvement in care delivery efficiency and outcomes. In collaboration with provider partners and THP colleagues, the senior analyst will:

  • Develop and refine data driven performance improvement plans for each provider partnership, ensuring alignment with applicable regulatory and contractual requirements, as well as organizational goals and priorities.
  • Develop implementation roadmaps consistent with the strategic plans, including timelines, milestones, metrics and responsibility assignments.
  • Oversee and monitor the execution of strategic plans, facilitate process improvement, systematically report on execution success, identify obstacles, barriers and challenges and make recommendations to address.

Requirements

JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES

EDUCATION:

  • Bachelor's degree. MPH or MBA highly desired.

EXPERIENCE:

  • 5+ years of experience with a proven track record of success in health care environment; health care consulting and/or analytics background preferred

SKILL REQUIREMENTS:

  • Solid understanding of the payer-provider industry; experience with government health care programs valued
  • Proven analytical skills and ability to manipulate and analyze large data sets as well as draw insights from data
  • Knowledge of SAS or other programming language (SQL/R).
  • Ability to take up ambiguous or complex business problems and work in a self-directed manner to problem-solve
  • Ability to work effectively across functions and with people at all levels including clinicians
  • Excellent communication skills, both oral and written

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS:

  • Must be able to travel within the Boston metro area to ACO locations frequently.


CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!

Please note: As of January 18, 2022, all employees - including remote employees - must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.

About Us:

Point32Health is a leading health and wellbeing organization, delivering an ever-better health care experience to everyone in our communities. Building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

 At Point32Health, we're working to reshape the world of health care by pushing past the status quo and delivering even more to the diverse communities we serve: more innovation, more access, more support, and healthier lives. And we want people like you on our side to make it even better.

This job has been posted by TalentBoost on behalf of Point32Health. TalentBoost is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of TalentBoost not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.

Req ID: R2886

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Details

  • Job Reference: 701275659-2
  • Date Posted: 1 September 2022
  • Recruiter: Point32Health
  • Location: Billerica, Massachusetts
  • Salary: On Application
  • Sector: Science & Technology
  • Job Type: Permanent