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Reporting to the Vice President of Strategic Analytics, the Director of Value-Based Care Analytics will lead strategic value-based care analytics work focused on contract and network performance, cost and utilization analysis, care management , quality and employer reporting. The director will work closely executive level clinical, operational, and financial leadership of the Baylor Scott & White Quality Alliance, the Scott & White Health Plan and Enterprise Analytics.
ESSENTIAL FUNCTIONS: - Consulting to identify non-beneficial clinical variation, reduce waste, and improve the cost-effectiveness and economic efficiency of population utilization, including both medical and pharmacy. - Lead strategy and execution of direct-to-employer reporting, provider analytics, network, clinical and financial outcomes - Confidently and knowledgeably present and discuss analysis results, insights, and recommendations to executive level internal and external stakeholders. - Ensure analytics will support key strategic decisions and incorporate relevant insights and sound data based on robust clinical, quality and business principles. - Perform trend analysis, predictive analytics, data mining and/or acquire outside research to provide actionable insights that inform strategic and tactical decisions that lead to improved patient and organizational value. Summarize findings and recommend actions. - Lead the design and development of analytical platforms, tools, and reports designed to understand key business levers to drive customer engagement and usage. - Oversee processes and architecture for data integrity and forecasting contract financial performance. - Ensures that data are translated into information that describes accurate and meaningful facts to customers with recommendations for action. - Collaborate with other analytics leaders and staff to align/further the overall contribution of the VBC Analytics team. - Work collaboratively with partners to define, develop, and deliver key metrics, dashboards, and related market intelligence programs and solutions across all aspects of population health and value-based care. - Identify and generate ad-hoc analysis to drive short-term strategies and accelerate change. - Proactively identify impactful business research. Develop and/or apply business intelligence to drive appropriate action and behavior, measurement and accountability aligned with key business initiatives. - Performs other position appropriate duties as required in a competent, professional and courteous manner.
KNOWLEDGE, SKILLS, and ABILITIES: - Expertise in medical and pharmacy claims data generation process, metrics, and analysis. - Expertise in provider data systems, measurement, and analysis including revenue cycle and electronic health records - Expertise in end-to-end value-based care analytics spanning delivery, quality, medical economics, benefits design, direct to employer and provider network performance - In-depth knowledge of health care benefits, health plan data science, actuarial and medical economics including reimbursement models - Exceptional problem-solving skills - both conceptual and analytical - Strong consulting and influencing skills with a collaborative approach - Experienced in making professional presentations to senior executives, both clinical and non-clinical, to convey complicated analytical material in a compelling manner - Work and lead independently yet collaboratively, with multiple functional areas. - Strong organizational, project management and time management skills - Ability to translate key learning and insights into actionable business strategies - Expertise creating data models and finding solutions when the data are ill-formed (incomplete and/or with errors etc. due to issues such as transactional and data management challenges)
QUALIFICATIONS: - Bachelor's degree or equivalent combination of education and experience required - 5+ Years of experience required
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!