Senior Risk Adjustment Data Analyst

Central California Alliance for Health; California (MO); Hybrid; USD 88,000 - 156,000; Full time

Job summary

A leading health organization is seeking a Senior Risk Adjustment Data Analyst to enhance risk adjustment performance. The role involves complex data analysis, project management, and collaboration with various teams to improve health outcomes and ensure regulatory compliance. Candidates should have a strong background in risk adjustment methodologies and data visualization tools.

Benefits

Medical insurance

Vision insurance

401(k)

Tuition assistance

Qualifications

• Minimum of five years in health care finance reporting and analytics.
• Experience in a Medicare environment.

Responsibilities

• Perform complex analytical data mining and reporting.
• Lead initiatives and provide program support.

Skills

SQL

Data Analysis

Collaboration

Education

Bachelor’s degree in Finance, Business, Information Technology

Tools

Tableau

Data Visualization Tools

Job description

Join to apply for the Senior Risk Adjustment Data Analyst role at Central California Alliance for Health

Join to apply for the Senior Risk Adjustment Data Analyst role at Central California Alliance for Health

Central California Alliance for Health provided pay range

This range is provided by Central California Alliance for Health. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$88,251.00/yr - $155,168.00/yr

We have an opportunity to join the Alliance as a Senior Risk Adjustment Data Analyst in the Risk Adjustment Department.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Risk Adjustment Director, this position will perform complex analytical data mining and reporting in support of the Risk Adjustment Department. You will also lead initiatives, provide program support, and perform project management related to data gathering and analysis as well as act as a subject matter expert and resource regarding risk adjustment data.

ABOUT THE TEAM

Risk Adjustment is a growing, specialized team that plays a critical role in ensuring accurate coding, appropriate reimbursement and data-driven insights that support the broader organizational goals of our health plan. Our team collaborates closely with internal and external partners to optimize risk adjustment performance across our future Medicare and current Medi-Cal programs. We are passionate about using data to improve our members' health outcomes, support the success of our provider partners, and ensure regulatory alignment.

THE IDEAL CANDIDATE

• Well versed in risk adjustment methodologies, particularly within the Medicare space
• Familiarity with risk adjustment models and their impact on plan performance and payment
• Proficiency in SQL, and an ability to analyze and translate complex healthcare data into meaningful and actionable insights, in addition to general reporting
• Experience with data visualization tools to present insights clearly and effectively
• Self-directed and proactive, with the ability to manage priorities and drive projects forward
• Strong collaborator who can work effectively with organizational teams, including IT, finance, operations, clinical and compliance teams

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here.

Knowledge of:

• Quantitative data analysis methodologies and analytical tools related to risk adjustment reporting and analysis
• Data modeling techniques and business analytical and data mining tools, including SQL, and data visualization tools, such as Tableau
• Medicare program and related regulations
• Medicare (Hierarchical Condition Categories) risk adjustment models
• Methods and techniques of developing and delivering data management strategies that support contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations

Ability to:

• Collect, interpret, and evaluate data, detect patterns, brainstorm solutions, consider multiple factors when making decisions, and project consequences of recommendations
• Perform technical and non-technical troubleshooting and diagnose and resolve complex problems, including problems that may have multiple variables and may not have obvious solutions
• Act as a technical resource, provide guidance related to area of assignment, and explain related regulations, processes, and programs
• Work collaboratively and productively with diverse project teams in order to achieve efficient and timely solutions

Education and Experience:

• Bachelor’s degree in Finance, Business, Information Technology, or a related field
• A minimum of five years of experience performing health care finance reporting and analytics, including a minimum of three years of experience working in a Medicare environment (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying.

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance, Accounting/Auditing, and Analyst

• Industries

  Hospitals and Health Care

Referrals increase your chances of interviewing at Central California Alliance for Health by 2x

Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Tuition assistance

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