Risk Adjustment Data Analyst I

Healthcare-Partners,-Mso-; Village of Garden City (NY); Sur place; USD 65 000 - 75 000; Plein temps

Avantages offerts par ce poste

Medical & Dental

PTO

401k

FSA

Tuition Reimbursement

Résumé du poste

HealthCare Partners, MSO in Garden City, NY is seeking an entry-level Risk Adjustment Integrity Analyst I to support analytics, data integrity, and regulatory compliance. You'll collaborate with internal teams and external partners to improve risk score accuracy and ensure compliant data submissions.

We value detail-oriented, analytical candidates with SQL and data tools experience, able to manage multiple projects, communicate findings clearly, and grow with our risk adjustment and health plan

Qualifications

• Bachelor’s degree in public health, healthcare administration, business, data analytics, or related field preferred.

Responsabilités

• Analyze risk adjustment and claims data to identify trends, data gaps, and improvement opportunities.
• Support the design and implementation of risk adjustment strategies across Medicare, Medicaid, Exchange, and Commercial lines of business.
• Assist with internal and external audits, including RADV, by preparing supporting data and documentation.
• Perform data quality checks and reconciliation of CMS file rejections, EDPS, RAPS, and 3M reports.
• Partner with vendors to track and support chart retrieval, data validation, and documentation improvement efforts.
• Collaborate with coding teams to ensure accurate and complete documentation for risk adjustment purposes.
• Develop and maintain dashboards, reports, and project trackers to support operational transparency and performance monitoring.
• Assist in the development and maintenance of internal policies and procedures aligned with CMS and state risk adjustment regulations.
• Communicate project status and insights through presentations, data summaries, and regular reporting.
• Participate in cross-functional workgroups focused on claims processing, provider education, and data submissions.
• Support provider engagement and training efforts by preparing materials and organizing sessions that promote accurate documentation and coding practices.
• Stay current on regulatory changes and support the implementation of compliance updates as needed.
• Lead or support operational projects related to chart reviews, risk score accuracy, encounter submissions, and vendor performance.

Connaissances

SQL

Analytical thinking

Healthcare data analysis

Microsoft Office

Data tools (Python, Tableau, SAS)

Formation

Bachelor’s degree in public health, healthcare administration, business, data analytics, or related field

High school diploma or equivalent

Outils

Python

Tableau

SAS

Excel

Description du poste

HealthCare Partners, MSO in Garden City, NY is seeking an entry-level Risk Adjustment Integrity Analyst I to support analytics, data integrity, and regulatory compliance. You'll collaborate with internal teams and external partners to improve risk score accuracy and ensure compliant data submissions.

We value detail-oriented, analytical candidates with SQL and data tools experience, able to manage multiple projects, communicate findings clearly, and grow with our risk adjustment and health plan