Data Scientist - ACO/VBC

Data Scientist, ACO & VBC Strategy

We are looking for a versatile Data Scientist to join our team to enter the Accountable Care Organization (ACO) & Value-Based Care (VBC) markets. You will play a critical role in analyzing, interpreting, and transforming healthcare data—particularly in the context of MSSP and REACH ACOs and VBC—into actionable insights for our Software as a Service (SaaS) solutions. Leveraging your strong analytical skills, domain expertise, and experience with data science tools, you will support key initiatives aimed at improving healthcare outcomes and operational efficiencies. You’ll work closely with cross-functional teams, including product managers, data engineers, and clients, to drive success in ACO and VBC environments.

Location: Remote (Candidates must reside in Georgia, Tennessee, or Pennsylvania)

Reports to: Manager, Data Scientist

Why You'll Love This Opportunity:

• You’ll be at the forefront of transforming healthcare data into actionable insights that empower MSSP and REACH ACOs and VBC organizations to make data-driven decisions.
• You’ll collaborate with a team passionate about improving healthcare outcomes through data.
• You’ll tackle diverse challenges in a dynamic, fast-paced environment, contributing to the future of value-based care.

Responsibilities:

• Act as a subject matter expert on data relevant to ACOs and VBC, including quality reporting, risk adjustment, and cost/utilization trends.
• Provide industry expertise on the operational and strategic challenges ACOs face, including population health management, financial benchmarking, regulatory compliance, and network performance.
• Interpret, analyze, and refine medical claims, quality metrics, and cost data to build actionable insights and support strategic initiatives by developing Python and SQL scripts.
• Provide industry expertise on the operational and strategic challenges ACOs face, including population health management, financial benchmarking, and regulatory compliance.
• Collaborate with product teams to scope, define, and prioritize data initiatives that align with client needs and regulatory requirements.
• Work extensively with ACO attribution models, ensuring accurate assignment of beneficiaries to providers and understanding the implications on roster building and cost analysis.
• Analyze and integrate BCDA & CCLF data to support insights into patient populations, utilization, and financial performance.
• Design and robust methodologies for calculating and applying risk adjustment factors to ensure equitable performance comparisons across populations and alignment with CMS policies.
• Design, document, and implement methodologies for calculating key performance indicators (KPIs) such as cost savings, quality scores, and patient outcomes.
• Communicate complex data findings and recommendations to both technical and non-technical stakeholders.
• Stay current on trends and regulations impacting ACOs and VBC, including CMS requirements and other healthcare policy updates.

What You Bring:

• Bachelor’s degree in a technical or healthcare-related field, or equivalent experience.
• 5+ years of professional experience in data analysis, preferably within ACOs, VBC, or healthcare analytics.
• Deep knowledge of medical claims data (e.g., Medicare, Medicaid, Commercial) and healthcare coding systems (ICD-10, CPT, HCPCS, HCCs).
• Expertise in replicating ACO and VBC-specific metrics and attribution methodologies.
• Experience working with BCDA & CCLF data and understanding its structure and applications in performance analysis.
• In-depth understanding of the healthcare industry's transition to value-based care, including familiarity with shared savings programs, risk contracts, and bundled payment models.
• Ability to develop and document data pipelines using SQL and Python in Databricks and Snowflake.
• Ability to independently manage projects and deliver high-quality data solutions.
• Excellent communication and problem-solving skills, with the ability to explain complex data insights to diverse audiences.

Why You'll Succeed:

• You have a passion for using data to improve healthcare outcomes within the ACO and VBC landscape.
• You thrive on solving complex problems and enjoy creating innovative solutions.
• You’re a self-starter who’s comfortable taking ownership of projects and collaborating with multidisciplinary teams.

This role is perfect for someone who is excited about the intersection of healthcare, data, and value-based care and who wants to make a meaningful impact on the healthcare industry. Join us in our mission to leverage data to drive better outcomes for patients and providers alike.