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Posted: 10/20/2026Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare analytics, risk adjustment methodologies, and value-based care economics, with a strong focus on data quality and stakeholder collaboration. Proficient in advanced statistical modeling and analysis of medical claims data to drive clinical outcomes and cost-effectiveness.
Highest-signal resume keywords
Healthcare/Clinical Analytics ExperienceAdvanced SQL ProficiencyPython or R Statistical ModelingRisk Adjustment Methodology KnowledgeClaims Data Analysis Experience
Tech Stack
Tools & technologiesAbout the role
Key responsibilities & impact- Build patient stratification and risk models for utilization risk, hospitalization/adverse event risk, and acuity tiers
- Own risk adjustment methodology and align it with payor and regulatory expectations
- Analyze medical and pharmacy claims data to identify utilization patterns, cost drivers, and gaps in care
- Lead cost-of-care and ROI analyses quantifying the value of family-led care
- Structure and analyze value-based care and risk-sharing arrangements
- Model shared savings, care management fees, and other value-based care contract structures
- Develop and validate methodologies, assumptions, and results for Finance, payor negotiations, actuaries, and audits
- Design clinical studies with the Clinical team and research health outcomes
- Own clinical quality and outcomes measurement aligned with HEDIS, Stars, and state Medicaid quality measures
- Build evidence through case studies, white papers, peer-reviewed publications, and conference presentations
- Partner with Finance on payor contract negotiations
- Collaborate with Clinical, Health Plan, Engineering, and Product teams on shared metrics, data models, and dashboards
- Establish measurement frameworks for clinical interventions, care protocols, and product/operational experiments
- Set company strategy and standards for measuring risk, cost, and outcomes
- Report to the Senior Manager of Data & Analytics
Requirements
What you’ll need- 5+ years of experience in healthcare/clinical analytics, health economics and outcomes research (HEOR), actuarial analytics, biostatistics, or population health
- Direct experience leading analytics for a business or clinical domain
- Advanced SQL
- Strong proficiency in Python or R, including statistical and predictive/risk modeling
- Hands-on experience analyzing payor claims data (medical and pharmacy)
- Familiarity with claims data structures and standard code sets, including ICD-10, CPT, and NDC
- Direct experience working with health plans, payors, or actuaries
- Experience designing and executing health outcomes studies
- Publication in peer-reviewed journals and/or presentation at industry conferences
- Deep knowledge of risk adjustment, cost of care/ROI methodology, value-based care economics, and clinical quality measurement
- Experience with dbt, Git, cloud data warehouses, and BI platforms
- High standards for data quality, rigor, and documentation
- Excellent communication and stakeholder-management skills
- Preferred: experience at a value-based care, population health, or risk-bearing healthcare organization
- Preferred: background in causal inference, survival analysis, or predictive modeling for clinical/financial risk
- Preferred: familiarity with Medicaid, Medicare, or dual-eligible populations
- Preferred: experience with prior authorization, revenue cycle, or patient lifecycle data
- Preferred: familiarity with data requirements of AI or agentic clinical systems
- Must be willing and able to work hybrid in San Francisco, CA
- Work authorization/sponsorship information is requested for the US
Benefits
Comp & perks- Competitive compensation packages
- Medical, dental, and vision insurance options
- $0 deductible PPO
- Company-funded HSA
- Employer-paid life and disability insurance
- Generous paid time off
- 10 paid company holidays
- HSA contributions
- Optional FSA and commuter benefits
- Full coverage of all 401(k) account fees (employer match not currently offered)
- Up to 10 weeks of paid parental leave based on tenure
- Equity
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Healthcare/Clinical AnalyticsRisk Adjustment MethodologyStatistical ModelingCost of Care AnalysisValue-Based Care EconomicsClaims Data AnalysisHealth Outcomes Studies DesignData Quality StandardsPredictive ModelingCausal Inference
Soft Skills
Excellent CommunicationStakeholder Management
Tools & Technologies
SQLPythonRDbtGitCloud Data WarehousesBI Platforms
Industry Keywords
Health EconomicsPopulation HealthValue-Based CareMedicaidMedicareDual-Eligible PopulationsICD-10CPTNDCPrior Authorization