Sr. Medicare Program Analyst

This is a Fully Remote Job About Our Client: The organization operates in the healthcare technology sector, focusing on enabling physician practices, health plans, and health systems. It addresses challenges related to optimizing physician performance, enhancing patient experiences, and promoting high-value care both in-person and virtually. Utilizing scalable operations and cloud-based technology, the program aims to reduce unnecessary healthcare costs, achieve better patient outcomes, and improve provider well-being. About the Opportunity: The SR. MEDICARE PROGRAM ANALYST role is designed to support Accountable Care Organizations (ACOs) within the Medicare Shared Savings Program (MSSP). This position provides critical analytics and insights to track performance, identify opportunities, and drive data-informed decisions that contribute to the success of value-based care initiatives. Responsibilities: Build and monitor key performance metrics including patient attribution, cost, utilization, risk stratification, and quality Track and analyze ACO and provider performance to identify actionable spending anomalies Evaluate CMS HCC risk adjustment scores to uncover performance gaps across providers Develop ad-hoc benchmarking and risk models comparing expenditures to CMS benchmarks Analyze CMS CCLF claims data to monitor total cost of care, out-of-network usage, and utilization trends Stay informed on policy and regulatory changes affecting value-based care programs, particularly MSSP Collaborate with IT, ACO leadership, and operations teams to support MSSP program objectives Requirements: Minimum of 2 years professional experience Bachelor’s degree preferred in healthcare or quantitative fields such as public health, engineering, analytics, economics, actuarial sciences, or statistics Experience with healthcare claims data, EMR, hospital data, coding systems (CPT, HCPCS, diagnosis, etc.), and claims adjudication preferred Intermediate proficiency in SQL and SAS Experience with Snowflake is preferred Strong communication skills to explain complex data insights and healthcare trends Ability to translate business needs into technical requirements and solutions Adaptability to changing priorities Relationship-building skills Critical thinking Proactive and self-motivated Pay Range and Compensation Package: Base salary range from $85,000 to $100,000 Eligibility for annual bonus targeted at 15% Compensation exclusive of benefits such as medical, dental, vision, life and pet insurance, 401(k), paid time off, and wellness programs Final base pay determined by experience, education, and location Benefits & Perks: Medical insurance Dental insurance Vision insurance 401(k) Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note: TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.