Senior Risk Adjustment Analytics Lead (Remote)

Advantmed; United States; Remote; USD 95.000 - 130.000; Vollzeit

Benefits dieser Stelle

Health Care Plan (Medical, Dental &amp

Annual Performance Bonus

Retirement Plan (401k, IRA)

Life Insurance (Basic, Voluntary &

Paid Time Off (Vacation, Sick &

Family Leave (Maternity, Paternity)

Short Term & Long Term Disability

Work From Home

Wellness Resources

Zusammenfassung

Advantmed, a leading provider of risk adjustment and value-based solutions, is seeking a Risk Adjustment Specialist to join the Data Analytics team. You will partner with clients, operations, technology, and leadership to translate complex health data into actionable insights that drive RAF improvement and revenue optimization.

The role emphasizes CMS-HCC and RxHCC methods, extensive SQL work, and cross-functional collaboration to support strategic decision-making.

Qualifikationen

• Bachelor's degree in Healthcare, Statistics, Computer Science, Engineering, Business Analytics, or related field.
• 5+ years of healthcare data analytics experience, including data mining, mapping, transformation, validation, and reporting.
• 3+ years of hands-on experience in Medicare Advantage and/or ACA Risk Adjustment.
• 3+ years of experience as a Healthcare Data Analyst.
• 3+ years of advanced SQL development experience.

Aufgaben

• Analyze Medicare Advantage and ACA Risk Adjustment program performance to identify opportunities for RAF improvement and revenue optimization.
• Provide expertise on CMS-HCC, RxHCC, Medicare Risk Adjustment methodologies, and industry best practices.
• Evaluate operational and financial performance metrics and develop data-driven recommendations.
• Support client-facing initiatives, business reviews, and executive presentations.
• Develop operational reports, scorecards, ad hoc analyses, and executive dashboards.

Kenntnisse

Healthcare analytics

Risk Adjustment

CMS data

SQL

Data visualization

Client engagement

Ausbildung

Bachelor's degree in Healthcare/Statistics/CS

Tools

SQL Server

SSMS

Power BI

Tableau

Excel

Jobbeschreibung

Advantmed, a leading provider of risk adjustment and value-based solutions, is seeking a Risk Adjustment Specialist to join the Data Analytics team. You will partner with clients, operations, technology, and leadership to translate complex health data into actionable insights that drive RAF improvement and revenue optimization.

The role emphasizes CMS-HCC and RxHCC methods, extensive SQL work, and cross-functional collaboration to support strategic decision-making.