Value Based Payor Performance Analyst, Full Time, First Shift

This role serves as a key analytical liaison between Managed Care, Finance, Population Health, Quality, operational leaders, and payer partners to ensure accurate external reporting, resolve performance discrepancies, maintain audit-ready documentation, and provide leadership with actionable contract performance insights. The analyst interprets payer performance methodologies and contractual requirements; validates and reconciles payer-reported quality, utilization, attribution, and financial results; and forecasts incentive attainment, shared savings, and revenue at risk.

Job Description

Under minimal supervision, the Value Based Performance Analyst is responsible for contract-level performance management, financial analysis, external quality reporting, and compliance oversight for UC Health commercial and government value-based care arrangements. The analyst interprets payer performance methodologies and contractual requirements; validates and reconciles payer-reported quality, utilization, attribution, and financial results; and forecasts incentive attainment, shared savings, and revenue at risk. This role serves as a key analytical liaison between Managed Care, Finance, Population Health, Quality, operational leaders, and payer partners to ensure accurate external reporting, resolve performance discrepancies, maintain audit-ready documentation, and provide leadership with actionable contract performance insights.

Responsibilities

• Monitors the performance of assigned value-based care contracts, including quality, utilization, patient attribution, and financial results.
• Tracks contract requirements, incentive opportunities, shared savings, and potential financial risks.
• Analyzes and forecasts contract performance, identifying trends, risks, and opportunities for improvement.
• Reviews payer calculations and compares them with UC Health's data to ensure accuracy.
• Prepares, validates, and submits required quality reports, scorecards, and supporting documentation to payers and regulatory programs.
• Interprets quality measure requirements, reporting guidelines, and contract provisions to ensure compliance.
• Maintains reporting schedules, documentation, and audit-ready records.
• Serves as a key contact for payer questions related to quality reporting and performance results.
• Monitors reporting deadlines, performance obligations, and compliance requirements for value-based care programs.
• Identifies reporting issues, compliance risks, and performance concerns, escalating significant issues to leadership.
• Tracks changes in payer and regulatory requirements and evaluates their impact on operations and financial performance.
• Reconciles payer performance reports with internal data, investigating and resolving discrepancies.
• Collaborates with Managed Care leadership and payers to address data, quality, attribution, and reimbursement issues.
• Tracks disputed items through resolution and quantifies the financial impact of variances.
• Develops performance dashboards, scorecards, and executive reports that summarize quality, utilization, financial results, and compliance status.
• Provides leadership with insights on performance drivers, risks, and opportunities to improve contract outcomes.

Qualifications

Minimum Required: Bachelor's Degree, 3-5 years equivalent experience in value-based contracting, payor performance, healthcare finance, managed care analytics, quality reporting, or healthcare reimbursement

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.

As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.

UC Health is an EEO employer.