ACO Program Analyst in Palm Springs, Florida at PBACO Holding LLC

ACO PROGRAM ANALYST

POSITION SUMMARY

The ACO Program Analyst is responsible for supporting the design, implementation, and ongoing performance management of value-based contracts and programs. This role is highly detail-oriented and data-driven, focusing on analyzing performance metrics, financial outcomes, and contractual obligations to ensure achievement of strategic goals. The analyst plays a critical role in driving measurable outcomes, identifying opportunities for improvement, and supporting decision-making through actionable insights.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Serve as a subject matter expert on payor portals and payor-provided reports, responsible for all downstream end user access

• Serve as the subject matter expert on payor onboarding, including management of the project plan, meeting deadlines, and liaising with other departments including quality, finance, clinical, data, and IT

• In partnership with the director, educate internal stakeholders on the contract and contract changes, and present these materials to internal and external stakeholders as necessary

• Analyze commercial value-based contracts to ensure compliance with contractual terms, quality metrics, and financial targets

• Monitor and evaluate program performance using data analytics, dashboards, and reports to identify trends, gaps, and improvement opportunities

• Support the development and tracking of key performance indicators (KPIs) related to cost, quality, utilization, and outcomes

• Navigate through large datasets and analyze data to determine trends, areas of opportunity, and improvement suggestions

• Prepare reports, presentations, and summaries for leadership to inform strategic decisions

• Ensure accuracy, completeness, and integrity of data used in analysis and reporting

• Assist in contract implementation activities, including operational workflows, reporting structures, and performance tracking

• Abide by all HIPAA, confidentiality, and privacy laws

• Handle customers' concerns in a helpful and objective manner

• Perform other duties as assigned by Supervisors and Managers

MEASURABLE OBJECTIVES AND GOALS

• Maintain timely and accurate tracking of assigned value-based contract performance metrics, including cost, quality, utilization, care gaps, and financial outcomes, in accordance with established reporting timelines

• Complete payor onboarding activities and assigned implementation milestones by agreed-upon deadlines, escalating risks or barriers to leadership in a timely manner

• Produce recurring reports, dashboards, and leadership summaries with a high level of accuracy, completeness, and consistency, supporting timely decision-making and performance improvement

• Identify trends, gaps, and opportunities in large datasets and provide actionable recommendations to support improvement in quality scores, cost performance, utilization management, and contract compliance

• Support closure of assigned care gap, attribution, reporting, or data integrity issues by coordinating with internal departments and payor partners as needed

• Demonstrate effective collaboration with Commercial, Quality, Finance, Clinical, Data, and IT stakeholders by providing clear updates, meeting preparation materials, and follow-through on assigned action items

SUPERVISORY RESPONSIBILITIES

This job has no supervisory responsibilities.

COMPETENCIES

To perform the job successfully, an individual should demonstrate the following competencies:

• Technological Skill – Experience with Microsoft Office (Word, Excel, PowerPoint, etc.), SQL, online portals, population health databases, etc.

• Knowledge of value-based care models, risk arrangements, and population health management

• Strong understanding of healthcare data, claims, and performance metrics

• Oral Communication – Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions

• Safety and Security – Uses equipment and materials properly

• Attendance/Punctuality – Is consistently at work and on time

• Knowledge of medical records work procedures

• Knowledge of computer applications

• Knowledge of medical terminology

• Knowledge of legal and ethical considerations related to patient information

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

• Bachelor's degree in Healthcare Administration, Finance, Business, Public Health, Data Analytics, or a related field required

• Experience in healthcare, value-based care, managed care contracting, or a related field preferred