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P3 Health Group Management, LLC Senior Healthcare Economics Revenue & Quality Analyst in Henderson, Nevada

Senior Healthcare Economics, Revenue & Quality Analyst

NV, AZ, OR, FL, CA

Overall Purpose:

At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.

We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.

We are looking for a Senior HealthCare Economics Analyst– Revenue Cycle and Quality Programs. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing national organization based in Las Vegas, Nevada, then consider joining our team! This role will support the comprehensive management of revenue data, reporting and analysis.

This role will perform the following for Revenue and CMS quality programs:

  • Perform advanced trend analytics to answer “what happened?”

  • Conduct root cause statistical analyses to answer “why did this happen?”

  • Develop predictive models to answer “what will happen next?” and “who is it likely to happen to?”

  • Mine data to answer “where are the opportunities?”

  • Develop methods/frameworks/models to answer “what kind of decision problem is this?”

  • Build models and deploy innovation processes and pilots to answer “how can we get better?”

  • Develop, support and manage reporting for internal management, health plan and provider partners to describe to various audiences “Here’s what happened, why it happened and where the opportunities are.”

    Responsibilities

  • Identify, analyze, interpret, and communicate revenue and quality trends to be consumed by management, provider partners and related entities.

  • Responsible for maintenance/management of existing reports, development of new reports to help ensure company goals are met, as well as other ad hoc requests as needed.

  • Recommend and guide process improvements that will ensure risk adjustment factor and disease burden data capture is complete and accurate.

  • Identify and lead internal subject matter experts in regular meetings to identify and rectify various data submission and adjudication errors related to risk adjustment data submission.

  • Assist Senior Analyst and Data Engineering team in developing and maintaining data sets leveraging internal data, response data from regulatory entities (MMR, MOR, RAPS Response, MAO-004, etc.), and ancillary data sources to be consumed across the enterprise.

  • Analyze effectiveness of vendor partners through analytic reconciliations to ensure regulatory compliance, optimal data submission and error resolution, and general accuracy.

  • Assist with root cause analysis to maintain high integrity data and processes to minimize discrepancies and gaps.

  • Assist in developing, maintaining, and reporting out on actionable metrics related to risk adjustment and incorporating quality/health outcome metrics where applicable.

  • Collaborate with internal and external partners to resolve data issues related to member, claim, provider and pharmacy data and processes.

  • Work with internal teams, provider partners, and vendor partners as needed to support revenue and quality activities.

    Qualifications

  • Bachelors degree in Mathematics, Statistics or related field, or a Healthcare field

  • 1+ years’ experience in financial analysis/healthcare economics/actuarial related to health information required.

  • Familiarity with Risk Adjustment Documentation and Coding practices preferred.

  • Medicare Stars and/or HEDIS experience preferred.

  • Equivalent work and education experience will be considered.

  • Previous experience conducting program evaluation, outcomes research and reporting

  • Some SQL experience required

EQUAL OPPORTUNITY EMPLOYER

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

DIVERSITY & INCLUSION

At P3, we recognize and appreciate the importance of creating an environment in which all team members feel valued, included, and empowered to do their best work and bring great ideas to the table

Every P3 family member's unique experiences, perspectives, and viewpoints are valued and support our ability to deliver the best possible experience for our patients, providers, payers, partners, and each other.

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