Covera Health - Manager, Performance Analytics
Requirements
• Deep hands-on fluency with healthcare claims data structures: professional and institutional claim formats, diagnosis and procedure coding, member and provider identifiers, and how eligibility files join to claims. • Direct experience with healthcare regulatory and quality reporting: Medicare Advantage risk adjustment data, including MAO-004 files, strongly preferred; familiarity with CDI (clinical documentation integrity) reporting, encounter data, or similar plan-side reporting a strong plus. • Demonstrated ability to build and run analysis independently, from SQL queries against large datasets through Excel and pivot-table analysis to finished output: these are working skills you use daily, not skills you manage in others. • Rigor about correctness: your numbers appear on invoices and settle compensation and client performance conversations, and you treat that accordingly. • Hypothesis-driven by habit: you ask the relevant questions, form a view, test it, verify the result, and repeat. We will ask what you built, what changed as a result, and what failed. • Fluency with value-based care: risk arrangements, care-gap economics, and what closure means clinically and financially. • Comfort operating without a large team: this is a builder-operator seat in a scaling program, with strong executive support and high visibility. • AI at Covera • At Covera Health, AI is not a novelty. It's a core part of how we work. Every team member is expected to actively use AI in their day-to-day role, and we invest in building that fluency across the organization. If you lean into new tools and are energized by what's still possible, you'll fit in.
Responsibilities
• Own the program’s analytics pipeline: intake and analysis of claims records, eligibility files, and • MAO-004 reconciliation data across all clients. • Own care-gap identification: the analysis that determines which validated findings represent open, addressable gaps. • Own closure reconciliation on the program's vintage-cohort, MAO-004-evidenced measurement basis, including the monthly cohort measurement cycle and the collection-method distinctions (current eligibility vs. retrospective) that determine how cohorts are read. • Own billing reconciliation: studies-analyzed and per-unit program activity reconciled to invoiced volume by client and by practice, at a standard that survives client audit. • Build funnel instrumentation: stage-level conversion from finding identified, to shared with the physician, to acted on, to closed, so the program can see where value leaks rather than only its cumulative totals. • Deliver practice-level performance analysis: which practices are converting, which need education or intervention, and where concentration or volume volatility creates program risk. • Deliver the program’s baseline restatement on the vintage-cohort measurement basis and stand up the monthly measurement cycle aligned to CMS reconciliation windows in your first 90 days. • Document, standardize, and progressively automate the pipeline in partnership with Product and Engineering, so the program’s measurement survives any individual.
Benefits
• Comprehensive medical plans - choose from three plans, including one with 100% of premiums covered for you and your dependents • Vision & Dental • Hybrid Time Off Policy (Flexible Time Off (FTO) Policy for exempt employees and Paid Time Off (PTO) Policy for non-exempt employees) • Sick days in accordance with your state law • 12 weeks of paid parental leave • 12 Fixed Holidays (company closed) • 401(k) Retirement Plan • Annual Professional Development Stipend to invest in courses, books, or any other professional development related activity • Annual Wellness stipend for fitness, mental health or other wellness expenses • The minimum and maximum base salary for this position ranges from $130,000 to $160,000, in addition to a discretionary bonus and comprehensive benefits package. Final compensation will be based on a number of factors including but not limited to, a candidate’s qualifications, skills, competencies, experience, expertise and location. • Please note • We may use automated tools and/or AI to assist in reviewing applications. • We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. Equal Opportunity is the Law, and Covera Health is proud to be an equal-opportunity workplace and affirmative action employer. If you have a specific need that requires accommodation, please let a member of the People Team know. • Unfortunately, job seekers are sometimes targeted by scammers pretending to represent legitimate companies, including Covera Health. Our recruiting team will only communicate with you using an @coverahealth.com email address. We will never ask you to provide banking information, payment, or other financial details as part of the interview or hiring process. If you're ever unsure whether a recruiting communication is legitimate, please contact our Talent Acquisition team at [email protected] for verification. • @coverahealth.com • [email protected]
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