Senior Health Economics Lead
Operations | San Francisco, CA | Full Time
At Vida, our mission is to eradicate chronic disease and transform people’s lives through improved health. There is huge potential to make an impact: 1 in 3 people in the U.S. has a chronic health condition, while 1 in 4 struggles with mental illness. Chronic conditions also represent a huge market opportunity at ~80% of our nation’s $3T in annual healthcare spend.
Vida is transforming healthcare through digital therapeutic programs and one-on-one health coaching and therapy to help individuals prevent, manage, and overcome chronic conditions. We apply data science and a human touch to drive a highly personalized experience through our easy-to-use mobile app. Our unique approach drives high user engagement, behavior change, and proven clinical outcomes.
Vida serves employees/members of Fortune 500 companies, large national payers, and leading health systems. We have both a B2C and B2B revenue model.
This position will lead health claims related analysis for Vida Health, leveraging payer claim data to drive effective marketing and enrollment strategies, shape/drive clinical interventions based on population trends, and monitor cost outcomes.
Establish infrastructure and needed processes to ingest and manage claims data exchange from multiple payers
Establish procedures to assess quality of incoming data, including completeness and accuracy, and work with account teams to resolve discrepancies
Establish appropriate data security and compliance processes for ingesting claims on a regular basis
Design, develop, and implement analyses that support target marketing and enrollment including member condition sets and medical service utilization patterns
Design, develop, and implement quantitative analyses on drivers of health care cost and utilization, leveraging health care claims and other sources of data
Lead approach for evaluating overall health economics and program evaluation
Work collaboratively with existing analysts and provide needed guidance and subject matter expertise on health claims related analyses
Work cross functionally with customer success and clinical teams to establish repeatable client facing reports leveraging claims data
Support research team needs on integrating claims data needs with existing processes
Support client-facing meetings on claims data needs repeatable analyses that
Minimum 5 years experience and knowledge of healthcare data and analytics
Knowledge of, and experience with, healthcare claims data and all related nomenclatures; demonstrated experience working with claims data
Solid understanding of Medical Claims, Rx Claims, Clinical Data, Eligibility, Provider Data and related processes
Experience with clinical coding systems: ICD9/10 diagnosis codes, ICD9/10 procedure codes, CPT codes, revenue codes, provider NPI codes, NDC Rx codes
Strong SQL and/or SAS programming experience, or similar tools.
Experience leading and implementing leveraging Tableau, and/or other tools for data visualization
Proficiency with basic statistics and management reporting.
Bonus points for:
Some clinical background or background leveraging analytics for clinical, population health initiatives
Experience with end-to-end implementation of healthcare claims reduction initiatives
Benefits & Perks
- Competitive compensation
- A health-oriented office culture including walking 1:1s, healthy food & snacks, fitness challenges and weekly yoga
- Health, vision, dental benefits
- Flexible vacation time
MORE ABOUT VIDA HEALTH: Vida provides expert, personalized, on-demand health coaching and programs from a network of experienced health care providers and leading medical institutions. Vida is a next generation continuous care platform for both consumers and businesses, combining a consumer mobile app, an enterprise care platform offering on demand 24/7 solutions for chronic conditions. Vida platform runs in the cloud, captures real-time data from 100+ devices and apps, and integrates back to the employer, payer, and provider.