Umpqua Health is a Coordinated Care Organization (CCO) in Roseburg, Oregon that serves over 30,000 OHP members within Douglas County, offering benefits, programs and outreach for those in need. Currently we are seeking a Value Based Payment Analyst to join our team.

• Full-time position. Roseburg, OR.
• Generous benefit package including; PTO, Health/Vision/Dental Insurance, 401k with a company match, gym membership reimbursement and more
• Salary is dependent upon experience.

The Value Based Payment Analyst is responsible for analyzing and reporting on value-based payment arrangements between health plans and healthcare providers. This role requires strong analytical and communication skills, as well as the ability to work with complex data sets and collaborate with other teams to identify opportunities for improvement and drive positive results. This position leads the analysis of health outcomes, quality of care, financial analysis, and health care utilization within the context of Value Based Payment (VBP) models. This includes performing statistical analysis using analytical tools, assisting in developing long-term plans that will meet the analytical needs of the organization, and assisting leadership in interpreting various provider opportunities and proposals. This position is the primary liaison with external and internal actuaries, as well as Network, Contract, and Decision Support staff supporting our provider network.

ESSENTIAL JOB RESPONSIBILITIES

• Provide strategic guidance to the health plan leadership team on value-based payment initiatives, identifying opportunities to optimize performance and improve quality.
• Perform statistical analysis using analytical tools, assisting in developing long-term plans that will meet the analytical needs of the organization, and assisting leadership in interpreting various provider opportunities and proposals.
• Participate in the creation of analytical plans and VBP proposals.
• Provide leadership in development, analysis and ongoing monitoring of VBPs, including risk agreements, capitated payments, Primary Care, Behavioral Health, and Specialty innovative payments programs, Durable Medical Equipment (DME), Implant, and Pharmaceutical VBPs, and other programs.
• Act as “data translator” between the actuarial/finance language to network appropriate presentations.
• Develop and present educational, training and program materials on VBPs for internal teams and Network partners.
• Using in-depth knowledge of the financial dynamics of the health-care industry, advise management relative to cost and utilization outcomes from different payment scenarios.
• Analyze administrative and clinical data, and assess its quality, validity and reliability.
• Use appropriate software tools to retrieve, edit and tabulate data from various databases and files.
• Study and analyze tables, graphs, charts and other statistics and report results in a variety of formats.
• Write reports, as needed, such as statistical studies, narrative reports, articles for publication; develop report summaries by explaining the significance of trends.
• Develop dashboards, scorecards, and other tools using data visualization tools such as Tableau, Power Point, Excel
• Develop algorithms, models and repeatable analytics tools to mature use and creation of data products at UHA to support the ongoing operations of VBPs.
• Contribute and actively participate in community of practice to improve skills and capabilities of all analysts at UHA.
• Propose and implement process improvements.
• Demonstrate cooperation and teamwork.
• Provide cross-training on specific job responsibilities.
• Meet identified business goals that contribute to departmental goals.
• Use knowledge of process improvement (flow charts, process observation, idealized design, etc.) to facilitate simplifying and standardizing processes and equipment whenever possible.
• Independently identify opportunities, gaps and process improvements, including monitoring customer and stakeholder requirements

• Author advanced queries for data manipulation
• Comply with organization’s internal policies and procedures, Code of Conduct, Compliance Plan, along with applicable Federal, State, and local regulations.

QUALIFICATIONS

• Bachelor’s degree in business administration, mathematics, statistics, computer science or finance or equivalent experience Minimum Five (5) years’ related experience required, including the following:
• One (1) year of experience in a healthcare data domain (e.g., Claims, Pharmacy, Clinical, Dental, etc.)
• Knowledge of Tableau Desktop/Creator.
• Strong technical writing skills required.
• No suspension/exclusion/debarment from participation in federal health care programs (eg. Medicare/Medicaid)

For more information or to apply visit our website at www.umpquahealthcareers.com

Drug-free Workplace:

Umpqua Health is committed to providing a drug-free workplace for its employees and the communities it serves. This position requires successful completion of pre-employment screening which includes, but is not limited to; drug screen, criminal and federal background check, and other licensure requirement verifications.