Senior Analyst/Manager, Incentive Programs

Department: Quality - Risk Adjustment
Location: 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801
Compensation: $90,000 - $130,000 / year
Description
About the Role
As Senior Analyst/Manager, Incentive Programs at Astrana Health, you will own the tracking, quantification, and reporting of performance and earned revenue across the health plan incentive programs in which Astrana participates, spanning Medicare Advantage, Medicaid, Commercial, Exchange, and ACO populations.
These programs are a material and growing share of Astrana's earned revenue, but terms, measure sets, payout curves, and data requirements differ by plan, line of business, and market. This role brings one quantified view to that landscape: what dollars are available, what we are on pace to earn, what we are at risk of leaving on the table, and where an incremental unit of operational effort produces the greatest return.
What You'll Do
Incentive Program Inventory & Revenue Opportunity Modeling
Maintain a current inventory of health plan incentive programs across all lines of business, including measure sets, payout structures, attainment thresholds, gates, data requirements, and payment timelines
Translate contract and program terms into a quantified revenue opportunity model at the plan, market, IPA, and measure level, and maintain a running view of dollars available, earned to date, and still achievable
Quantify the marginal value of each incremental gap closed so effort and spend can be directed toward the highest yield measures
Performance Monitoring & Measure Prioritization
Monitor performance against payout thresholds throughout the year, with attention to measures sitting near a tier boundary in either direction
Identify high value measures using dollar weight, distance to threshold, denominator size, remaining runway, and feasibility, and set internal targets tied to payout tiers rather than generic benchmarks
Provide early warning when projected performance will miss a threshold, while there is still time to intervene
Executive Reporting, Forecasting & Risk Identification
Produce monthly executive reporting covering year to date performance and revenue earned, projected year end performance and revenue, and change versus prior month and prior year with drivers
Build dashboards and recurring reporting that are legible without an analyst present, and present findings, risks, and recommendations to senior leadership and in board, health plan, and market reviews
Maintain a consistent, documented, auditable projection methodology so month over month movement reflects real performance change rather than methodology drift
Surface the largest revenue opportunities and downside risks with quantified impact, a recommended owner, and a recommended action, and track them to resolution
Reconcile Astrana's internal performance view against health plan reported results, investigate variances, and identify systemic causes including missing supplemental data, encounter submission gaps, attribution errors, and measure logic misalignment
Cross-Functional Strategy & Data Management
Partner with the Chief Quality Officer and the President of Physician Enterprise to inform strategy and resource allocation across Quality, Utilization and Care Management, Encounter Submission, and Member Experience
Support health plan contract negotiation with analysis of historical performance, achievability of proposed thresholds, and expected value under alternative terms
Ingest, normalize, and reconcile data from plan reports, portal extracts, flat files, claims and encounter data, EMR feeds, and vendor files into repeatable, documented pipelines
Establish data quality checks and reconciliation controls, document known data limitations, and partner with data engineering on durable reporting infrastructure as the function scales
Qualifications
Bachelor’s degree in a quantitative, public health, health policy, business, or related field, or equivalent practical experience
3+ years (Senior Analyst) or 5+ years (Manager) of analytic experience in a health plan, IPA, MSO, or provider organization
Working knowledge of HEDIS and Medicare Stars measure specifications, including administrative, supplemental, and hybrid data sources
Familiarity with value-based care economics: pay-for-performance, shared savings, withholds, and capitated risk
Strong SQL and advanced Excel, working independently against large and imperfect datasets
Demonstrated experience building recurring executive reporting and translating analysis into a defensible recommendation
Comfort with ambiguity in source data, the judgment to know when a number is good enough to act on, and the discipline to state the confidence level
Excellent written and verbal communication with senior executives, and the accountability to manage multiple concurrent reporting cycles
Preferred Qualifications
Direct experience with Medicare Advantage Star Ratings, Medicaid quality withhold or incentive programs, or ACO REACH and MSSP quality reporting
Experience reconciling internal performance calculations against health plan reported results, and reading and operationalizing health plan incentive contract language
Proficiency with BI tools (Power BI, Tableau, Looker) and with Python or R
Environmental Job Requirements and Working Conditions
This position is remotely based in the U.S. The home office is located at 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801.
This role is required to attend occasional in-person meetings with internal departments or health plan partners.
The national target pay range for this role is between $90,000 - $130,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

Work arrangement
No