Senior Analyst, Health & Risk Solutions - Cost of Care, Granular
Verily
Who We Are
Verily is a subsidiary of Alphabet that is using a data-driven approach to change the way people manage their health and the way healthcare is delivered. Launched from Google X in 2015, our purpose is to bring the promise of precision health to everyone, every day. We are focused on generating and activating data from a variety of sources, including clinical, social, behavioral and the real world, to arrive at the best solutions for a person based on a comprehensive view of the evidence. Our unique expertise and capabilities in technology, data science and healthcare enable the entire healthcare ecosystem to drive better health outcomes.
Description
Granular Insurance is a subsidiary of Verily. Granular’s mission is to empower self-funded employers to better manage their health risk with its innovative and data-driven Precision Risk platform of solutions. Granular’s Precision Risk delivers better health outcomes and meaningful, long-term financial predictability via more precise underwriting, risk segmentation, and actionable insights into cost drivers.
The Senior Analyst, Health & Risk Solutions - Cost of Care will work in the Health & Risk Solutions department of Granular Insurance and identify and lead multiple initiatives to support our Precision Risk Stop Loss product and drive their execution with our Ecosystem Partners. This role will identify high cost claimant populations, underlying cost drivers, and implement cost containment strategies to make healthcare more affordable and to deliver financial predictability for our self-insured clients.
Responsibilities
- Identifies clinical composition of high risk members, comparing inbound data to actuarial benchmarks by identifying members on their rising risk predictors using the clinical condition input to evaluate segmentation for clinical or network programs.
- Develops best practices and cost containment strategies and benefit designs around outpatient, inpatient, pharmacy and professional spend, underwriting and claim reimbursement operations.
- Assesses the ecosystem to leverage innovative solution partners and programs to ensure that our members receive high-value and appropriate care.
- Investigates claim, case and underwriting data for performing healthcare cost analysis and develops savings measurement models to identify and implement strategies to control costs.
- Works on projects assigned on ecosystem partner assessment/ engagement and strategizing cost containment opportunities in partnership with clinical team, IT, account management and business partners.
Qualifications
Minimum Qualifications
- Undergraduate degree (BA/BS) with 3+ years of experience in a managed care, health plan, payor or provider related field and 5+ years of healthcare industry experience.
- Acumen in two or more of the following areas: Financial, Actuarial, Medical Economics, Affordability, Population Health, Clinical Analytics and Project Management.
- Working knowledge of ICD10, DRG, CPT codes, Bill Reviews and PPO contracts.
Preferred Qualifications
- MBA, MHA, MA
- PMP or Six Sigma Green Belt
- Prior experience with one or more of the following : claims processing, clinical strategy, finance or operations.
- MS Office Suite of tools desired, advanced Excel experience, SQL, Tableau or other reporting tools
- Strong strategic thinking, problem solving and communication skills.
The US base salary range for this full-time position is $100,000 - $120,000 + bonus + benefits. Our salary ranges are determined by role, level, and location. The range displayed on each job posting reflects the minimum and maximum target for new hire salaries for the position across all US locations. Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training. Your recruiter can share more about the specific salary range for your preferred location during the hiring process.
Please note that the compensation details listed in US role postings reflect the base salary only, and do not include bonus or benefits.
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Why Join Us
Build What’s Vital.
At Verily, you are a part of something bigger. We are a diverse team of builders innovating at the intersection of health and technology—united by a shared spirit of curiosity, resilience and determination to make better health possible for all. This builder mindset means your fingerprints will be on the work that shapes the future of health.
Fulfilling our precision health purpose starts with the health of our Veeps, which is why we offer flexibility, resources, and competitive benefits to support you in your whole-person well being.
Our culture reflects the behaviors that stem from living our values every day in how we Innovate Healthcare and Technology, Gain Velocity as One Verily, and Respect Individuals. As One Verily, we uphold our collective accountability to sustain this culture and to create a VIBE (Verily’s Culture of Inclusion, Belonging, and Equitability) where all Veeps feel included, a sense of belonging, and have opportunities to grow.
If this sounds exciting to you, we would love to hear from you.
You can find out more about our company culture on our LinkedIn Company Page and Verily Careers page.
