Senior Population Health Analyst: Risk Adjustment Insights

Walt Disney; Seattle (WA); Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

PTO & holidays

401(k) match

Health insurance

Tuition reimbursement

Job summary

MVP Health Care is seeking a Health Analytics Specialist to advance Medicare, Commercial Exchange, and Medicaid/HARP analytics and reporting. The role focuses on risk adjustment initiatives, data-driven targeting, and translating complex data into actionable insights.

Proficiency in SQL and data visualization tools (Tableau, Power BI) and strong communication are essential to improve program targeting and ROI. Some travel is required to support organizational goals.

Qualifications

• Minimum Education: Bachelor’s Degree in Health Administration, Business, Economics, Health Informatics, or related field.
• Minimum Experience: 2 years in a business environment involving analysis of financial or other large data sets.

Responsibilities

• Perform analytics and reporting on Medicare, Commercial Exchange, and Medicaid/HARP member populations.
• Serve as analytical lead on prospective and retrospective population health management objectives, focusing on Risk Adjustment efforts.
• Lead co-workers on design targeting based upon disparate data sources to identify members with likely risk gaps.
• Provide regular reporting of Risk Adjustment programs and identify opportunities and obstacles.
• Measure capture rate of Hierarchical Condition Categories (HCCs) and diagnosis codes related to Risk Adjustment programs to improve and optimize program targeting for Medicare and commercial exchange populations.
• Use Clinical Risk Group (CRG) software to target interventions for improved coding for Medicaid members.
• Calculate ROI for Risk Adjustment programs.
• Maintain regulatory requirements for CMS and NYS related to supplemental data.
• Minimal travel required.
• Perform other duties as assigned.

Skills

Lead analytics

Project management

SQL

Data visualization

Communication

Attention to detail

Time management

Independent work

Data analysis

Tableau

Power BI

R

Python

Education

Bachelor’s Degree in Health Administration, Business, Economics, Health Informatics, or related field

Tools

Tableau

Power BI

Excel

R

Python

Job description

MVP Health Care is seeking a Health Analytics Specialist to advance Medicare, Commercial Exchange, and Medicaid/HARP analytics and reporting. The role focuses on risk adjustment initiatives, data-driven targeting, and translating complex data into actionable insights.

Proficiency in SQL and data visualization tools (Tableau, Power BI) and strong communication are essential to improve program targeting and ROI. Some travel is required to support organizational goals.