Senior Analyst, Medicaid ACO

Posted: 07/18/19 Category: Healthcare IT Job Number: 7530

Position Title: Senior Analyst, Medicaid ACO

Job Location:  Greater Boston Area

Interview Expectations:  onsite

Local Candidate: yes

Required Skill Sets: Must have Medicaid exp, ACO exp, SQL, Payer


Reporting to the Analytics Manager, the Senior Analyst serves as the key analytic resource to meet the information, reporting, and analytic needs of the Medicaid Accountable Care Organization.


As a critical member of the SHCN Analytics Team, the Senior Analyst performs the following functions:

• Conducts sophisticated business analyses to support Medicaid ACO program development and ongoing operations, grounded in deep expertise and functionality with both internal and publicly available Medicaid-related health care data sources

• Develop comprehensive, timely and accurate analyses, reports and presentations on utilization, leakage, risk performance, care management, and quality metrics on Medicaid ACO care risk contracts for SHCN' s Medicaid ACO

• Deliver accurate and on-time deliverables, including dashboard reports, cost estimates, models and ad-hoc analyses

• Track and evaluate key performance metrics

• Work with business and operational leaders to identify TME opportunities and quantify ROI for related programs

• Coordinate with  internal data, analytics, and information technology teams to manage data and reporting related to Medicaid programs

• Identify opportunities to improve and enhance the analysis and information provided to SHCN leadership, participating network providers, and community partner organizations 

• Work with analysts and analytic tool vendors to improve standard report design  

• Support ad hoc analytic requests, providing accurate and timely data, analysis and insightful interpretations


• Possess strong analytic and technical skills plus an ability to translate complicated data into useable information; 

• Ability to work on multiple projects simultaneously, deliver work products on deadline, and respond to new requests with fast turn-around, as needed

• Strong skills in SQL, Excel, PowerPoint; one or more years of BI tool experience preferred (Qlik, Tableau)

• Ability to be thorough and be careful about details

• Excellent working knowledge of statistics

• Organizational and project management skills to manage projects effectively;

• Demonstrated knowledge of relationships between health plans and providers, including detailed understanding of health plan data and familiarity with Medicaid and other public programs;  

• Possess an in-depth understanding of claims data, including ICD-9 & CPT codes, DRGs, health status and risk adjusters; 

• Excellent verbal and written communication skills, including the ability to graphically present complex data; outstanding interpersonal skills; and ability to relate positively with individuals at all levels of the organization  

• Creative, flexible, and self-motivated with sound judgment; ability to plan and implement;

• Commitment to service excellence


Education:  BA/BS required; Master' s degree preferred.
Experience:  Three to five years of relevant experience in healthcare, analytics, or informatics. 
Certification/Licensure:  N/A
Software/Hardware:  MS Office, SQL/SAS, Qlik, Tableau and/or other query/analytic tools.

Matthew Poplawski
Technical Recruiter

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