Staff Healthcare Analyst

ABOUT ABBY CARE: POWERING THE FUTURE OF CARE AT HOME FOR ALL OF AMERICA. Abby Care is building the leading AI-native platform for family-led care. America is facing a growing care crisis. Millions more people need care at home than ever. Over 50 million family caregivers support loved ones without the tools, training, or recognition they deserve. We believe families are the largest untapped caregiving workforce in America, and that technology can help them deliver better care while driving stronger outcomes and greater transparency across the healthcare system. Abby Care combines clinical oversight with an AI-powered platform to train, enable, and support family caregivers in delivering high-quality care at home. Our platform helps health plans and government partners better understand, verify, and improve care in the home. We expand access to care, reduce reliance on higher-cost settings, and help ensure public dollars are spent effectively. We are proud to partner with leading health plans, providers, and community organizations and are backed by top VCs. We envision a future where family-led care is a core part of the healthcare system. Abby Care is building that future. Join us in solving one of the most important challenges of our time. THE OPPORTUNITY: We are looking for a Staff Healthcare Analyst at Abby Care. The role leads efforts spanning patient risk modeling and clinical outcomes measurement to the cost and value analysis behind the story we bring to health plans, payors, and government partners. The role is expected to be the subject matter expert for clinical and health economics analytics at the company. Reporting to the Senior Manager of Data & Analytics, you will set the strategy and standards for how we measure risk, cost, and outcomes, and build the analytical models and studies that prove the value of family-led care. You will develop the methodology, evidence, and analysis that our Clinical, Finance, and executive teams rely on in conversations with payors, actuaries, and research partners. You will work hand-in-hand with our Clinical and Health Plan teams, and closely with Finance, Engineering, and Product on the cross-functional initiatives that power this work. This is a full-time, hybrid role based in San Francisco, California. WHAT YOU'LL WORK ON: Population health & risk - Build patient stratification and risk models (e.g., utilization risk, hospitalization/adverse event risk, acuity tiers) that inform care prioritization and intervention design. - Own risk adjustment methodology (e.g., HCC/RAF-style approaches) and ensure it aligns with payor and regulatory expectations. - Analyze payor claims data (medical and pharmacy) to identify utilization patterns, cost drivers, and gaps in care, and to inform and validate risk models. Health economics & value-based care - Lead cost of care and ROI analyses (total cost of care, cost offset, medical loss ratio impact) that quantify the value of family-led care for health plans and government partners. - Structure and analyze value-based care and risk-sharing arrangements; model shared savings, care management fees, and other VBC contract structures. - Develop and validate the methodology, assumptions, and results that Finance rely on when negotiating with payors and actuaries and responding to audits. Clinical outcomes & evidence generation - Design clinical studies in partnership with the Clinical team to research and publish health outcome studies (e.g., readmission reduction, caregiver burden, quality of life), following rigorous study design and biostatistics practices. - Own implementation of clinical quality and outcomes measurement, including alignment to industry-standard frameworks (e.g., HEDIS, Stars, state Medicaid quality measures) where relevant to our health plan partners. - Build the evidence base (case studies, white papers, peer-reviewed publications, conference presentations) that establishes Abby Care as a credible, data-backed player in home-based care. Cross-functional partnership - Partner with Finance to bring clinical and health economics analysis into payor contract negotiations, arming the negotiation team with evidence on cost offset, outcomes, and value. - Partner closely with Clinical, Health Plan, Engineering, and Product teams to define shared metrics, data models, and dashboards that create a single source of truth for clinical and financial performance. - Establish measurement frameworks, in collaboration with relevant teams, for clinical interventions, care protocols, and product/operational experiments. WHAT YOU'LL HAVE: - 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: you can speak their language and hold your own in methodology discussions and contract conversations, even if you're not the one at the negotiating table. - 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: you can translate complex analysis into something Finance, Clinical, and leadership can use with confidence in front of payors and actuaries. - High standards for data quality, rigor, and documentation. Preferred Qualifications: - Experience at a value-based care, population health, or risk-bearing healthcare organization (e.g., 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 unique cost/quality dynamics. - Experience with prior authorization, revenue cycle, or patient lifecycle data. - Familiarity with the data requirements of AI or agentic clinical systems. BENEFITS: - Competitive compensation packages that reflect the value you bring. We reward our team for the impact of their work. - Comprehensive health coverage that works for you. Choose from high-quality medical dental and vision options, including a $0 deductible PPO and a company-funded HSA, alongside employer-paid life and disability insurance. - Generous paid time off. We provide policies that allow you to recharge along with 10 paid company holidays. - Financial savings benefits to support your future. We support your financial well-being with HSA contributions, optional FSA and commuter benefits, and full coverage of all 401(k) account fees (employer match not currently offered). - Paid parental leave to support your growing family. We provide up to 10 weeks of paid parental leave based on tenure, so you can focus on bonding and adjusting to life as your family grows. OUR VALUES 1. Families First Redefining healthcare starts with how we treat the parents and children we serve. We go above and beyond for every family, building strong, lasting relationships. We continually ask ourselves, “Would we want this for our own families?” 2. Urgency with Precision Millions of families are waiting for care, and they cannot wait, therefore this is not your typical 9 to 5 job. We match their urgency with our own, delivering exceptional care without compromise. Here, speed and excellence go hand in hand. 3. Relentlessly Resourceful As an ambitious startup, we adapt quickly and make the most of limited time and resources. We solve challenges with creativity to deliver results without unnecessary complexity. 4. Purpose with Positivity We take our mission seriously while never losing sight of the people behind the work. Respect, kindness, memes, and coffee make us stronger as a team and better for the families we serve. 5. Driven to Redefine What’s Possible We are here to make healthcare better, which means asking hard questions, challenging outdated systems, and finding smarter, more compassionate ways to deliver care. Equal Opportunity Employer Abby Care is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, contact talent@abbycare.org. Abby Care considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, Philadelphia, and New York City Fair Chance laws. We are an E-Verify participating company. Automated Decision Tools 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. We believe that these tools help ensure objective, data-based decisions during the hiring process, however, 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.