Sr. Analyst of Risk Adjustment Data

Bring your experience with healthcare analytics experience to an established insurer and play an active role in submission, monitoring, and contributing to the end-to-end Risk Adjustment Data Submission and Validation. You will be responsible for oversight and participation in projects including timeline development & maintenance as it pertains to encounter and risk adjustment data. What You'll Be Doing: You'll perform analysis and reporting activities for risk score calculation, data submission, chart review programs and audits, and related performance metrics per regulatory and health plan guidelines. Collaborate with internal and external stakeholders and contribute to the creation of technical documents and high-level solution designs. You will research and document encounter errors in established systems using statistical trend analysis and perform root cause analysis for these encounters developing recommendations based on data and industry standards. You'll develop, test, and implement system specifications and conduct gap analysis, data collection, and validation for risk adjustment activities. You'll be a major part of program improvement through designing and implementing business process and system changes. What You'll Need for Success Bachelors degree in Computer Science, Data Science, or related analytical field. Masters degree is a plus. 5+ years of experience in analytics/programming within healthcare, insurance, or related field. 2+ years of SAS programming Prior experience with large amounts of clinical and medical claims data The base salary range for this role is $108,000 to $115,000 with a 10% bonus. This base salary range represents the low and high end of the base salary range for this position. Actual base salary offered will vary based on various factors including but not limited to location, level, job-related knowledge, skills, experience, and performance.

Created: 2024-11-05