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Abby Care is building an AI-native platform for family-led care, partnering with health plans and government agencies to improve home-based care delivery and outcomes. The company combines clinical oversight with technology to train and support family caregivers while providing health plans with better visibility and measurement of care quality and cost-effectiveness.
As Staff Healthcare Analyst, you will be the subject matter expert for clinical and health economics analytics, reporting to the Senior Manager of Data & Analytics. You will set strategy and standards for measuring risk, cost, and outcomes across the organization, and build the analytical models and studies that demonstrate the value of family-led care to payors and government partners.
Key responsibilities span three domains:
**Population Health & Risk:** Build patient stratification and risk models (utilization risk, hospitalization/adverse event risk, acuity tiers) to inform care prioritization. Own risk adjustment methodology (HCC/RAF-style approaches) aligned with payor and regulatory expectations. Analyze payor claims data (medical and pharmacy) to identify utilization patterns, cost drivers, and care gaps.
**Health Economics & Value-Based Care:** Lead cost of care and ROI analyses (total cost of care, cost offset, medical loss ratio impact) quantifying family-led care value. Structure and analyze value-based care and risk-sharing arrangements, modeling shared savings and care management fees. Develop and validate methodology and assumptions for payor negotiations and audit responses.
**Clinical Outcomes & Evidence Generation:** Design clinical studies with the Clinical team to research and publish health outcome studies (readmission reduction, caregiver burden, quality of life) following rigorous biostatistics practices. Own implementation of clinical quality and outcomes measurement aligned to industry standards (HEDIS, Stars, state Medicaid measures). Build the evidence base through case studies, white papers, peer-reviewed publications, and conference presentations.
You will partner closely with Finance, Clinical, Health Plan, Engineering, and Product teams to define shared metrics, data models, and dashboards, and establish measurement frameworks for clinical interventions and product experiments.
**Requirements:**
- 5+ years of experience in healthcare/clinical analytics, health economics and outcomes research (HEOR), actuarial analytics, biostatistics, or population health, with direct experience leading analytics for a business or clinical domain
- Advanced SQL and strong proficiency in Python or R, including statistical and predictive/risk modeling
- Hands-on experience analyzing payor claims data (medical and pharmacy), including familiarity with claims data structures and standard code sets (ICD-10, CPT, NDC)
- Direct experience working with health plans, payors, or actuaries; ability to engage in methodology discussions and contract conversations
- Demonstrated experience designing and executing health outcomes studies, including publication in peer-reviewed journals and/or presentation at industry conferences
- 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
- Excellent communication and stakeholder-management skills; ability to translate complex analysis for Finance, Clinical, and leadership audiences
- High standards for data quality, rigor, and documentation
**Preferred Qualifications:**
- Experience at a value-based care, population health, or risk-bearing healthcare organization (Medicaid MCO, home-based care company)
- Background in causal inference, survival analysis, or predictive modeling for clinical/financial risk
- Familiarity with Medicaid, Medicare, or dual-eligible populations and their cost/quality dynamics
- Experience with prior authorization, revenue cycle, or patient lifecycle data
- Familiarity with data requirements of AI or agentic clinical systems
