Sr. Data Analyst, Risk Adjustment

The Sr. Data Analyst, Risk Adjustment will be primarily responsible for risk adjustment modeling and analysis for Medicare, ACA, & Medicaid populations, but may also be required to develop or complete other healthcare data analysis. To succeed in this role, you should be analytical, resourceful, and have a complete understanding of Medicare Advantage ACA, Medicaid, Risk Adjustment models, and concepts. You should also be an excellent oral and written communicator who is able to tell the story behind raw data to non-technical audiences.

Responsibilities

• Develop and maintain risk adjustment calculation engines using appropriate data sources and software
• Create standard Risk Adjustment analysis and metrics, such as same -store analysis, incremental lift, gap analysis, and HCC/code recapture.
• Interpret CMS Advance Notices, and Federal Register documentation
• Analyze/Clean/Load/Stage payer data from disparate sources into centralized data marts
• Delve into data to discover discrepancies and patterns

• Present and explain information analysis in an accessible way to internal stakeholders and external partners
• Collaborate with management and internal teams to implement and evaluate improvements.
• Analyze enrollment/eligibility, claims or other health plan data.

Requirements

• Expert knowledge of CMS-HCC, HHS-HCC and risk adjust models
• Familiarity or working knowledge of state-specific CDPS Medicaid models.
• BSc/BA in Health Informatics, Statistics, Mathematics, Actuarial Science, or a related field preferred
• 2-3+ years proven experience as a Healthcare Data Analyst (Emphasis on Risk Adjustment Calculations)
• 2-3+ years of experience in data analysis and BI Software (Tableau, Power BI, SSRS)
• 3+ years’ experience writing SQL preference for MS T-SQL, SQL Server, and SSMS
• Experienced in executing SAS-based Risk Adjustment modeling desired
• Ability to work in a fast-paced environment with minimal direction
• Knowledge of Extract, Transform and Load (ETL) processes

• Experience with Enterprise Data Warehouse (EDW) and data management systems
• Excellent analytical and communication skills
• Outstanding organizational and problem-solving aptitude

Benefits

WORKING AT VATICA HEALTH ADVANTAGES

Prosperity

• Competitive salary based on your experience and skills – we believe the top talent deserves the top dollar
• Bonus Potential (based on role and is discretionary) – if you go above and beyond, you should be rewarded
• 401k plans– we want to empower you to prepare for your future
• Room for growth and advancement- we love our employees and want to develop within

Good Health

• Comprehensive Medical, Dental, and Vision insurance plans
• Tax-free Dependent Care Account and Flexible Spending Account
• Life insurance, short-term, and long-term disability

Happiness

• Excellent PTO policy (everyone deserves a vacation now and then)
• Great work-life balance environment- We believe family comes first!
• Strong supportive teams- There is always a helping hand when you need it

Are you up to the challenge? What are you waiting for? Apply today!