InnovaCare Management Services Company, LLC

Key Responsibilities:

• Analyze performance across value-based care contracts (Medicare Advantage, ACO, shared savings, full-risk arrangements).
• Interpret risk adjustment data (RAF scoring, HCC coding) and identify areas for coding accuracy improvement.
• Develop and present insights on care gaps, admissions, readmissions, ER and SNF utilization, and other key performance indicators (KPIs).
• Work closely with care coordination teams and primary care providers to provide data that supports high-risk patient outreach and care gap closure.
• Support payer for data reporting, compliance, and regulatory reporting obligations (CMS, state requirements).
• Translate complex clinical and claims data into actionable recommendations for stakeholders including executives, clinicians, and operational leaders.
• Maintain and enhance dashboards in Tableau, Power BI, or similar tools to visualize trends and opportunities.
• Partner with IT and data engineering to ensure data accuracy, consistency, and availability.

Technical Skills:

• Proficiency in SQL and Excel; ability to write queries and manipulate large datasets.
• Strong experience with Tableau, Power BI, or similar visualization platforms.
• Experience with Python or R for data analysis a plus.
• Understanding of medical coding (ICD-10, CPT) and healthcare claims structure.

Qualifications:

• 2-4 years of experience in healthcare analytics, preferably within Medicare Advantage, Medicaid managed care, or value-based primary care.
• Bachelor's degree in healthcare administration, Public Health, Health Informatics, Biostatistics, or a related field (master's preferred).
• Experience working with claims, EMR, and clinical data, especially in risk-bearing organizations or MSOs.
• Experience with CMS risk adjustment models (HCC), RAF scoring, and VBC (Valued Base Care) contract performance metrics.
• Strong communication skills with experience presenting to clinical and executive audiences.

InnovaCare Health is committed to improving the lives of our patients and providers through innovation and quality-focused care. If you're a data-driven problem solver with a passion for healthcare transformation, we'd love to hear from you.

The information listed above is not comprehensive of all duties/responsibilities performed. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.