Abby Care is building an AI-native platform for family-led care, combining clinical oversight with technology to support caregivers and improve outcomes in home-based care.
This role leads analytics across patient risk modeling, clinical outcomes measurement, and health economics/value analysis. You will serve as the subject matter expert for clinical and health economics analytics, helping prove the value of family-led care to health plans, payors, and government partners.
The position reports to the Senior Manager of Data & Analytics and works closely with Clinical, Finance, Engineering, and Product teams on cross-functional initiatives. This is a full-time, hybrid role based in San Francisco, California.
What you'll work on
- Build patient stratification and risk models for utilization, hospitalization, adverse events, and acuity tiers.
- Own risk adjustment methodology and ensure alignment with payor and regulatory expectations.
- Analyze medical and pharmacy claims data to identify utilization patterns, cost drivers, and care gaps.
- Lead cost of care and ROI analyses, including total cost of care, cost offset, and medical loss ratio impact.
- Model value-based care and risk-sharing arrangements such as shared savings and care management fees.
- Design clinical studies and support publication-quality research on outcomes such as readmission reduction, caregiver burden, and quality of life.
- Implement clinical quality and outcomes measurement using frameworks such as HEDIS, Stars, and state Medicaid quality measures.
- Partner with Finance, Clinical, Health Plan, Engineering, and Product teams to define shared metrics, data models, dashboards, and measurement frameworks.
Qualifications
- 5+ years of experience in healthcare analytics, health economics and outcomes research, actuarial analytics, biostatistics, or population health.
- Advanced SQL skills and strong proficiency in Python or R for statistical and predictive modeling.
- Hands-on experience analyzing medical and pharmacy claims data, including familiarity with ICD-10, CPT, and NDC code sets.
- Direct experience working with health plans, payors, or actuaries.
- Experience designing and executing health outcomes studies, with peer-reviewed publication and/or conference presentation experience preferred.
- Deep knowledge of risk adjustment, cost of care/ROI methodology, value-based care economics, and clinical quality measurement.
- Experience with dbt, Git, cloud data warehouses, and BI platforms.
- Strong communication and stakeholder management skills.
- High standards for data quality, rigor, and documentation.
Preferred experience
- Experience in value-based care, population health, or risk-bearing healthcare organizations such as Medicaid MCOs or home-based care companies.
- Background in causal inference, survival analysis, or predictive modeling for clinical or financial risk.
- Familiarity with Medicaid, Medicare, or dual-eligible populations.
- Experience with prior authorization, revenue cycle, or patient lifecycle data.
- Familiarity with data requirements for AI or agentic clinical systems.
Benefits and perks
- Competitive compensation package.
- Comprehensive medical, dental, and vision coverage, including a $0 deductible PPO option and company-funded HSA.
- Employer-paid life and disability insurance.
- Generous paid time off and 10 paid company holidays.
- HSA contributions, optional FSA and commuter benefits.
- Full coverage of 401(k) account fees.
- Up to 10 weeks of paid parental leave based on tenure.
Location
San Francisco, California, US
Employment Type
Full-time
Experience Level
Senior
Salary Range
$180,000 - $220,000
Remote work allowed
No
Posted
1 month ago