Senior Medicare Program Analyst

Privia Health

. Support Accountable Care Organizations (ACOs) in the MSSP program .

Posted 10/30/2026full-timeRemote • United StatesSenior💰 $85,000 - $100,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in analyzing healthcare claims data and performance metrics to provide actionable insights for Accountable Care Organizations (ACOs) within the MSSP program. Proficient in SQL and SAS for data analysis, with a strong understanding of VBC policy and regulations.

Highest-signal resume keywords

Healthcare Claims Data AnalysisSQL ProficiencySAS ProficiencyMSSP Program KnowledgeData-Driven Decision Making

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisPerformance TrackingRisk StratificationCost Utilization AnalysisHealthcare CodingClaims AdjudicationStatistical ModelingKPI TrackingBenchmark ComparisonAnalytics Development

Soft Skills

Critical ThinkingProactive AttitudeEffective CommunicationFlexibilitySelf-Motivation

Tools & Technologies

SQLSASSnowflakeEMR SystemsCMS CCLF Claims Data

Industry Keywords

Accountable Care OrganizationsMSSP ProgramValue-Based CareHealthcare Performance IndicatorsPublic HealthQuantitative Analysis

Tech Stack

Tools & technologies

SnowflakeSQL

About the role

Key responsibilities & impact

Support Accountable Care Organizations (ACOs) in the MSSP program
Track performance in the MSSP program using established KPIs
Communicate performance wins and issues
Provide actionable insights to ACOs for data-driven decision-making
Track patient attribution, cost, utilization, risk stratification, and quality performance
Build actionable analytics for participating TINs and providers highlighting spend anomalies
Evaluate CMS HCC risk adjustment scores to identify provider-network performance gaps
Build ad-hoc models comparing actual ACO expenditures with CMS historical and regional benchmarks
Analyze CMS CCLF claims data to monitor total cost of care, out-of-network leakage, and utilization trends
Champion understanding of VBC policy and regulations, particularly MSSP
Collaborate with IT, ACO leaders, and Operations teams

Requirements

What you’ll need

2+ years of professional experience
Bachelor’s Degree preferred; healthcare (e.g. public health) or quantitative major (e.g. engineering, analytics, economics, actuarial sciences, statistics)
Experience in healthcare claims data, EMR, hospital admission and discharge data, healthcare codes (CPT/HCPCS/provider specialty, diagnosis, place of service, revenue), healthcare claims adjudication (claim payments, adjustment/reversals, denials) preferred
Intermediate level experience with SQL and SAS
Snowflake experience preferred
Ability to communicate complex assessments and insights derived from data, CMS guidelines, ACOs’ performance indicators, regional, and national healthcare trends to a variety of audiences
Ability to distill analytical findings into clear insights and action steps
Ability to translate complex business problems to technical requirements and design solutions
Ability to remain flexible with changing priorities
Critical thinker
Proactive and self-motivated
Minimum 5 MBPS download speed and 3 MBPS upload speed for remote work, acquired prior to employment
Ability to work remotely from the United States

Benefits

Comp & perks

Medical insurance
Dental insurance
Vision insurance
Life insurance
Pet insurance
401K
Paid time off
Wellness programs
Annual bonus targeted at 15%
Remote work
Expense reimbursement for employees who regularly work from home offices