Manager, Medical Economics

About Stellar Health:Historically, US Healthcare has relied on a fee-for-service reimbursement system where providers are paid based on the quantity of patient visits and procedures, rather than the quality of health outcomes. At Stellar Health, we help primary care providers put patient health first. Our platform - a mix of technology, people, and analytics - supports providers at the point of care, delivering real-time patient information, activating practice staff, and empowering providers and care teams with incentives that reward the work they are already doing to keep patients healthy. Using the Stellar App, our web-based, point-of-care tool; practices receive a simple checklist of recommended actions that support the best quality care. Providers and care teams are then paid monthly for each action they complete, and Payors save money in reduced healthcare costs along the way. Stellar is a US-based Health-tech backed by Top VCs (General Atlantic, Point72, & Primary Venture Partners) with an established product & proven operating model. We've shown that we make a real difference for physician practices and their patients.About the Position:This role is critical to creating the underlying business intelligence, performance measurement and target setting for Stellar Health's ACO and all value-based risk contracts. This hire will work and collaborate closely with ACO Leadership, risk adjustment and quality experts, and provider performance management teams. The Manager, Medical Economics will help drive overall surplus performance in Stellar's ACO and Payor Risk Contracts by utilizing standardized medical economics tools (e.g. Milliman Insights) to determine performance needs in major functional areas (total cost of care, quality, risk adjustment, AWV completion), drilling down to understand providerregion specific opportunities as well as trends and communicating with key stakeholders to support their generation of performance management strategies and measurement of impact.This is an exciting individual contributor role where you'll get to lead & execute analyses across the breadth of Value-based Care levers and insights. What You'll DoGrowth Analytics: Using Stellar data, CMS publicly available data andor purchased data - identify Medical groups that are good targets for Stellar to grow with in our ACO or via other global capitation contracts Support negotiations with health plans by identifying key levers of Stellar performance within the contract and creating models to show range of opportunity or risk Attribution & Risk Adjustment Accuracy Analytics: Within the ACO, use claims data to identify potentially attributable patients, patients at-risk of losing attributionWork with performance management teams to identify strategies to maintain andor grow membershipCreate ACO and Medical Group-level reporting showing attribution opportunities and risksCreate and model impact of risk adjustment accuracy efforts; assist with setting targets where relevant Identify areas of potential risk adjustment inaccuracy for Performance & Operations teamsMedical EconomicsUsing standardized medical claims data & industry-standard tooling (such as Milliman Insights): Project contract financial performance on all relevant contracts (including but not limited to the ACO) Identify & report on cost and utilization trends Develop standardized views and complete ad hoc analyses to identify high cost patients, disease states, or provider-level views Lead Stellar cross-functional Medical Economics committee meeting to review findings and discuss intervention opportunities Create standardized Revenue & Cost of Care reporting for Medical Groups, including development & identification of a standard set of "key opportunities" for medical groupsConduct Impact Assessment:Analyze clinical interventions to evaluate their impact on patient utilization and cost of care.Develop and apply methodologies to isolate the effects of interventions, attributing changes in utilization and cost to specific programs or initiatives.Advise on study design set-up in order to enable sound impact assessments (e.g. preferred method (prepost vs controltreatment), target sample size, target experiment period, etc.Statistical Analysis:Leverage advanced statistical methods to analyze healthcare data.Perform hypothesis testing to determine whether observed changes in utilization or cost are statistically significant, providing confidence in terpret and communicate statistical results, including p-values, confidence intervals, and effect sizes, to key stakeholdersAs an Manager, Medical Economics you should have:6+ years experience working in an analytical role with internal stakeholders to answer business questionsActuarial designation preferred, but not requiredExperience analyzing and summarizing medical claims data (inclusive of utilization and cost) Experience with Value-based contracting design Medical economic cost modeling, reportingtrending, and identification of opportunitiesRisk adjustment (MAMSSP) knowledgeStrong proficiency in SQL and ExcelStrong proficiency with one or more BI tools (Tableau, Looker, PowerBI) )for data analysis and visualization.Experience working in a cloud-based data warehouse environment like Snowflake or DatabricksMust be able to turn Excel and SQL analyses into usable presentations and memos for consumption across different teamsaudiencesWho Will Love this Job:You have a deep passion for empowering the goals of value-based care in the primary care environmentYou have experience understanding and explaining population health trends, and want to be part of a solution that creates highly actionable insights for providersYou are an analytics expert but can work cross-functionally with leadership, product and financeYou get things done and you love working in a dynamic environment; we move quickly and we need a teammate who will tooYou are highly analytical, can structure unstructured problems and work messy data effectively, and can push consistently toward an answer under uncertaintyPay:The salary range for this role is $140,000 - $180,000 and will be eligible for an annual performance based bonus and equity grant. Where a new hire falls within this range will be based on their individual skills and experience, and how these competencies compare across other employees in the same role. Stellar's bands are designed to allow for individual compensation growth within the role. As such, new hires typically start at the lower end of the range. Stellar rewards performance and outcomes - should you join the company, you will have the opportunity to grow your salary over time.Stellar reserves the right to change our compensation bands at any time.Perks & Benefits:Stellar offers a carefully curated selection of wellness benefits and perks to our employees:Medical, Dental and Vision BenefitsUnlimited PTOUniversal Paid Family LeaveCompany sponsored One Medical memberships and Citibike membershipsMedical Travel Benefits A monthly wellness stipend that gives employees the freedom to choose where they spend their cash, whether it be on wellness, pet care, childcare, WFH items, or charitable donationsStock Options & a 401k matching programCareer development opportunities like Manager Training, coaching, and an internal mobility programA broad calendar of company sponsored social events that for our in-office and remote employeesDiversity is the key to our success. Stellar Health is an equal opportunity employer and we are open to all qualified applicants regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or expression, veteran status, or any other legally protected status. We believe that diverse teams -and the different identities, cultures, and life experiences our team members bring to the table- enable us to create amazing products, find creative solutions to interesting problems, and build an inclusive working environment. Stellar Health Employment Privacy NoticeAt Stellar Health, your privacy and security as a job seeker is a priority no matter where you are in the interview process. As recruiting scams have become more prevalent, please take note of the following practices to ensure the legitimacy of any interaction with our team. Please note that any communication from our recruiters and hiring managers at Stellar Health about a job opportunity will only be made by a Stellar Health employee with an @stellar.health email address. Stellar Health does not utilize third-party agencies for recruitment services and does not conduct text message or chat-based interviews. Any other email addresses, agencies, or forums may be phishing scams designed to obtain your personal information. We will not ask you to provide personal or financial information, including, but not limited to, your social security number, online account passwords, credit card numbers, passport information, and other related banking information until we begin onboarding activities, which will be coordinated by a member of the Stellar Health People Ops Team with an @stellar.health email address. If you are ever unsure whether you are in contact with a legitimate Stellar Health teammate, please contact . If you believe you've been a victim of a phishing attack, please mark the communication as "spam" and immediately report it by contacting the U.S. Federal Trade Commission.

Created: 2024-12-11