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You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Value-based care is a key strategy in transforming healthcare to improve outcomes, advance quality, and promote equity. The Analyst, Value-Based Payment Initiatives (VBP) will support the expansion and performance of Medicare-focused VBP arrangements across New York, including Medicare Advantage and Dual Eligible Special Needs Plans (D-SNPs). This role is critical in analyzing provider performance, modeling contract terms, and generating insights to guide strategic decision-making. The Analyst will work closely with the VBP Manager, Director, and cross-functional teams to support contract implementation, performance tracking, and reporting needs. This includes identifying cost and quality trends, supporting provider engagement efforts, and ensuring alignment with CMS-aligned risk-based models. The Analyst will play a key role in helping the organization drive population health improvements and financial sustainability through Medicare VBP strategies.
* Partner with Contract management and Service Fund teams to implement monitoring of Medicare-specific VBP contracts, including models with upside/downside risk, shared savings, and global capitation.
* Analyze provider performance against contract benchmarks (e.g., total cost of care, Stars measures) and prepare routine reporting for internal and external stakeholders.
* Identify trends and performance drivers to support provider outreach efforts and inform opportunities for improvement or innovation in VBP strategies.
* Assist in building and refining Medicare contract models, incorporating CMS and NYSDOH guidelines related to risk adjustment, quality metrics, and financial benchmarks.
* Collaborate with internal teams (e.g., Actuarial, Clinical, Legal, and Provider Relations) to align on incentive structures, attribution methodologies, and provider engagement needs.
* Track changes in CMS policy, Stars metrics, and VBP guidance to help ensure analytical work and contract support align with current requirements.
* Prepare analyses, data visualizations, and summaries to support contract negotiations, governance discussions, and strategic planning led by the Medicare VBP Manager.
* Advance efforts in health-related social needs strategies aimed addressing non-medical factors that influence health outcomes and equity across the delivery system.
* Recommend reporting enhancements based on VBP partner feedback and needs identified through regular use of the reporting tools.
* Special projects as assigned or directed.
Education/Experience: BA/BS – Bachelors Degree Required. MBA/MHA/MPH Preferred. Graduate education in health care administration or other related areas preferred. Minimum of 1-3 years of relevant healthcare operation or policy experience. Ability to communicate with internal and external business partners effectively. Strong written and oral communication skills. Knowledge of population health management, medical expense and quality performance analysis preferred.
Please note: it is highly preferred the candidate be located within commuting distance of our Long Island City, NY office for a hybrid schedule of 2-3 days in office per week.
Pay Range: $55,100.00 - $99,000.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
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