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 including stock options
- A health-oriented office culture including walking 1:1s, healthy food & snacks, fitness challenges, and weekly team runs
- Health, Vision, Dental Benefits
- Flexible vacation time
- FSA and Commuter benefits
- 401K (no company match at this 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.