Cone Health
Lead Analytics Manager - Value Based Care
Oct 09, 2025 The Lead Value-Based Care Analytics Manager oversees development and leads presentation of advanced analysis for clinical, financial and operational performance leveraging healthcare claims, clinical, operational and related data sources. This role plays a critical part in evaluating and informing strategic decision-making across the enterprise, especially regarding value-based care and risk-based programs. The manager supports team members in learning and development, works closely with key stakeholders across the enterprise, engages with CMS and national and regional payors, and regularly presents analysis, findings and recommendations to senior leaders. This role is part of our Value-Based Care Institute (VBCI) products and analytics team and works with minimal direct supervision. Key Responsibilities
Lead data analysis and performance monitoring for value-based contracts, ensuring accurate reporting of key performance indicators such as total cost of care, quality measures, risk scores, utilization, and shared savings metrics. Develop, implement, and monitor dashboards and reports to track contract performance and identify improvement opportunities. Support financial forecasting and impact modeling for value-based and risk-based arrangements, including CMS, CMMI, Medicare Advantage, Medicaid, Commercial, and Direct-to-Employer programs. Analyze benchmark methodologies, trend factors, and attribution logic to support negotiations and strategy. Measure and evaluate quality performance against HEDIS, STAR ratings, CMS quality programs, and custom metrics. Collaborate with clinical teams to identify gaps in care and improvement opportunities. Provide analytic support for the design, implementation, and evaluation of new value-based arrangements and translate complex payer contract terms into measurable analytic goals. Partner with senior leaders across the enterprise and care continuum to support value-based care analysis and performance improvement, and oversee the development of executive summaries and board-level reporting. Education
Formal training or work experience in data analytics, data analysis, or data science. Minimum of 10 years of experience; bachelor’s degree counts for 3 years, master’s for 1 additional year, doctorate for 2 additional years. Experience
Extensive experience with healthcare data sources: claims data, payor revenue/premium, supplemental, clinical quality metrics (HEDIS), risk adjustment (HCCs), social determinants of health (SDOH), and operational KPIs. Expert-level experience using SQL and at least one analytics or visualization tool (PowerBI, Tableau, SigmaComputing) and modern data infrastructure (Snowflake or Databricks). Proven ability to oversee data quality and integrity, manage vendor work, and engage with data engineering teams. Deep knowledge of healthcare claims analytics tools (e.g., Milliman MedInsight, MedeAnalytics, Tuva) and electronic health records (Epic, Cerner, eCW, Allscripts, Athena). Strong communication skills, able to convey complex analysis to non-technical leaders through verbal, written, and visual formats. Demonstrated curiosity to dive deep into healthcare data, uncover insights, and drive continuous learning within cross‑functional teams. Preferred experience: agile delivery environment (DevOps) and population health management platforms (Epic Value Based Care, Innovaccer, Arcadia, Lightbeam). Equal Opportunity Employer
We strive to create a welcoming atmosphere that celebrates a diverse and unique workforce. We believe in offering equal opportunities for employment to all applicants and employees, regardless of protected characteristics. Our hiring and employment choices are based on each individual's qualifications, skills and performance.
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Oct 09, 2025 The Lead Value-Based Care Analytics Manager oversees development and leads presentation of advanced analysis for clinical, financial and operational performance leveraging healthcare claims, clinical, operational and related data sources. This role plays a critical part in evaluating and informing strategic decision-making across the enterprise, especially regarding value-based care and risk-based programs. The manager supports team members in learning and development, works closely with key stakeholders across the enterprise, engages with CMS and national and regional payors, and regularly presents analysis, findings and recommendations to senior leaders. This role is part of our Value-Based Care Institute (VBCI) products and analytics team and works with minimal direct supervision. Key Responsibilities
Lead data analysis and performance monitoring for value-based contracts, ensuring accurate reporting of key performance indicators such as total cost of care, quality measures, risk scores, utilization, and shared savings metrics. Develop, implement, and monitor dashboards and reports to track contract performance and identify improvement opportunities. Support financial forecasting and impact modeling for value-based and risk-based arrangements, including CMS, CMMI, Medicare Advantage, Medicaid, Commercial, and Direct-to-Employer programs. Analyze benchmark methodologies, trend factors, and attribution logic to support negotiations and strategy. Measure and evaluate quality performance against HEDIS, STAR ratings, CMS quality programs, and custom metrics. Collaborate with clinical teams to identify gaps in care and improvement opportunities. Provide analytic support for the design, implementation, and evaluation of new value-based arrangements and translate complex payer contract terms into measurable analytic goals. Partner with senior leaders across the enterprise and care continuum to support value-based care analysis and performance improvement, and oversee the development of executive summaries and board-level reporting. Education
Formal training or work experience in data analytics, data analysis, or data science. Minimum of 10 years of experience; bachelor’s degree counts for 3 years, master’s for 1 additional year, doctorate for 2 additional years. Experience
Extensive experience with healthcare data sources: claims data, payor revenue/premium, supplemental, clinical quality metrics (HEDIS), risk adjustment (HCCs), social determinants of health (SDOH), and operational KPIs. Expert-level experience using SQL and at least one analytics or visualization tool (PowerBI, Tableau, SigmaComputing) and modern data infrastructure (Snowflake or Databricks). Proven ability to oversee data quality and integrity, manage vendor work, and engage with data engineering teams. Deep knowledge of healthcare claims analytics tools (e.g., Milliman MedInsight, MedeAnalytics, Tuva) and electronic health records (Epic, Cerner, eCW, Allscripts, Athena). Strong communication skills, able to convey complex analysis to non-technical leaders through verbal, written, and visual formats. Demonstrated curiosity to dive deep into healthcare data, uncover insights, and drive continuous learning within cross‑functional teams. Preferred experience: agile delivery environment (DevOps) and population health management platforms (Epic Value Based Care, Innovaccer, Arcadia, Lightbeam). Equal Opportunity Employer
We strive to create a welcoming atmosphere that celebrates a diverse and unique workforce. We believe in offering equal opportunities for employment to all applicants and employees, regardless of protected characteristics. Our hiring and employment choices are based on each individual's qualifications, skills and performance.
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