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About the Role
Abby Care is seeking a Staff Healthcare Analyst to lead efforts in patient risk modeling, clinical outcomes measurement, and cost/value analysis. This role requires subject matter expertise in clinical and health economics analytics, reporting to the Senior Manager of Data & Analytics. You will define strategies for measuring risk, cost, and outcomes, and build analytical models to demonstrate the value of family-led care.
Responsibilities
- Build patient stratification and risk models to inform care prioritization and intervention design.
- Own risk adjustment methodology and ensure alignment with payor and regulatory expectations.
- Analyze payor claims data to identify utilization patterns, cost drivers, and gaps in care.
- Lead cost of care and ROI analyses to quantify the value of family-led care.
- Structure and analyze value-based care and risk-sharing arrangements.
- Develop and validate methodology, assumptions, and results for payor negotiations and audits.
- Design clinical studies to research and publish health outcome studies.
- Own implementation of clinical quality and outcomes measurement, aligning with industry frameworks.
- Build the evidence base (case studies, white papers, publications) to establish credibility.
- Partner with Finance to integrate clinical and health economics analysis into payor contract negotiations.
- Collaborate with Clinical, Health Plan, Engineering, and Product teams to define shared metrics and data models.
- Establish measurement frameworks for clinical interventions, care protocols, and 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 (e.g., ICD-10, CPT, NDC).
- Direct experience working with health plans, payors, or actuaries.
- 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.
- High standards for data quality, rigor, and documentation.
Skills
- Healthcare Analytics
- Health Economics
- Outcomes Research (HEOR)
- Actuarial Analytics
- Biostatistics
- Population Health
- SQL
- Python
- R
- Statistical Modeling
- Predictive Modeling
- Risk Modeling
- Payor Claims Data Analysis
- Value-Based Care
- Risk Adjustment
- Cost of Care Analysis
- ROI Analysis
- Clinical Quality Measurement
- dbt
- Git
- Cloud Data Warehouses
- BI Platforms
- Communication
- Stakeholder Management
Location
- San Francisco, California
Work Type
- Full-time
- Hybrid
Experience Level
- 5+ years of experience
Benefits
- Competitive compensation packages
- Comprehensive health coverage (medical, dental, vision)
- High-quality medical, dental, and vision options
- $0 deductible PPO
- Company-funded HSA
- Employer-paid life and disability insurance
- Generous paid time off
- 10 paid company holidays
- Financial savings benefits
- HSA contributions
- Optional FSA
- Commuter benefits
- Full coverage of all 401(k) account fees
- Paid parental leave (up to 10 weeks based on tenure)
About the Company
- Abby Care is building the leading AI-native platform for family-led care.
- America is facing a growing care crisis with millions needing care at home.
- Over 50 million family caregivers support loved ones without adequate tools, training, or recognition.
- Abby Care believes families are the largest untapped caregiving workforce and technology can empower them.
- The platform combines clinical oversight with AI to train, enable, and support family caregivers.
- Abby Care helps health plans and government partners understand, verify, and improve care in the home.
- The company expands access to care, reduces reliance on higher-cost settings, and ensures public dollars are spent effectively.
- Abby Care partners with leading health plans, providers, and community organizations.
- The company is backed by top VCs and envisions family-led care as a core part of the healthcare system.
Equal Opportunity
- Abby Care may use automated decision tools to help match and rank candidate work experience, education and skills found in online profiles, resumes and job applications against job requirements.
- All Abby Care hiring decisions involve final human review and input.
- If you have questions or would like to request an alternative process, contact talent@abbycare.org.