Senior Risk Adjustment Data Analyst - Remote

Sentara Health; Richmond (VA); Remote; USD 60,000 - 102,000; Full time

Job summary

Sentara Health is seeking a Senior Risk Adjustment Data Analyst to work remotely, predominantly analyzing health data to improve revenue management processes. The role demands expertise in data analysis, SQL and collaboration on risk adjustment initiatives. Ideal candidates possess a Bachelor’s degree and experience in medical economics or related fields, exhibiting strong problem-solving and communication skills.

Benefits

Medical, Dental, Vision plans

Tuition Assistance – $5,250/year

401k/403B with Employer Match

Adoption, Fertility and Surrogacy Reimbursement up to $10,000

Paid Time Off and Sick Leave

Qualifications

• 3-5 years in data analysis, predictive modeling.
• Must have advanced knowledge of SQL and Databricks.
• Ability to explain complex processes to non-technical audiences.

Responsibilities

• Provide data analysis support to the Revenue Management team.
• Design and implement processes using varied data sets.
• Create and manage tables in the revenue management sandbox.

Skills

Data Analysis

Predictive Modeling

SQL

Databricks

Problem Solving

Communication

Education

Bachelor's Degree in Mathematics, Statistics, Finance, Economics, or Computer Science

Job description

Join to apply for the Senior Risk Adjustment Data Analyst - Remote role at Sentara Health

Join to apply for the Senior Risk Adjustment Data Analyst - Remote role at Sentara Health

Overview:

Sentara Health is looking for a Senior Risk Adjustment Data Analyst to join our team!

West Virginia

The Senior Risk Adjustment Data Analyst provides data analysis supports to Sentara Health Plans’ Revenue Management team, affiliated internal departments, and external vendor partners. The Senor RA Analyst supports in designing and implementing processes and solutions utilizing a wide variety of data sets to resolve business challenges in relation to optimizing Risk Adjustment premium revenue. The senior analyst uses a combinations of data/text mining, analysis, reporting, predictive and risk modeling to support informed business decisions. This requires complete understanding of claims, pharmacy, lab, network utilization, and cost containment data. Additionally, familiarity with external data sources including Medicare, Medicaid, and Health Exchange data files is required.

City/State

Richmond, VA

Work Shift

First (Days)

Overview:

Sentara Health is looking for a Senior Risk Adjustment Data Analyst to join our team!

This position is 100% Remote, but candidates must have a current residence in one of the following East Coast states, or be willing to relocate: Delaware, Florida, Georgia, Maine, Maryland, New Hampshire, North Carolina, Pennsylvania, South Carolina, Virginia , West Virginia

The Senior Risk Adjustment Data Analyst provides data analysis supports to Sentara Health Plans’ Revenue Management team, affiliated internal departments, and external vendor partners. The Senor RA Analyst supports in designing and implementing processes and solutions utilizing a wide variety of data sets to resolve business challenges in relation to optimizing Risk Adjustment premium revenue. The senior analyst uses a combinations of data/text mining, analysis, reporting, predictive and risk modeling to support informed business decisions. This requires complete understanding of claims, pharmacy, lab, network utilization, and cost containment data. Additionally, familiarity with external data sources including Medicare, Medicaid, and Health Exchange data files is required.

The Senior RA Data Analyst is required to show independent thinking. The senior analyst assists in identifying business challenges, support development of processes to address the challenges, and metrics to track and monitor business processes. This requires a high level of understanding of Centers for Medicare and Medicaid (CMS), Health and Human Services (HHS), or Virginia Department of Medical Assistance (VA-DMAS) Risk Adjustment programs. The Senior RA Data Analyst must

• Serve as SME for standard analytic suites using EDP data sources for membership data and claims.
• Create and manage tables in the revenue management sandbox.
• Design table layouts and collaborate with the enterprise data team to develop new tables.
• Partner with architecture teams to build new and necessary data sources.
• Project Involvement: Collaborate with vendors on risk adjustment initiatives.
• Created necessary reports for business and regulatory use.
• Automated existing reports to improve efficiency.
• Developed and maintained dashboards for data visualization.
  
  
  

Education

Bachelor's Degree in Mathematics, Statistics, Finance, Economics, Computer Science, or related

Certification/Licensure

• No specific certification or licensure requirements
  
  
  

Experience

• 3 - 5 years in data analysis, predictive modeling, Medical Economics or related
• Advanced Knowledge of SQL AND databricks is required.
• Ability to break out complex technical processes and explain to non-technical audiences
• Understanding of Prospective and Retrospective Risk Adjustment Interventions preferred
• Excellent Oral and Written Communication Skills
• Problem Solving
• Consultative Engagement Skills
  
  
  

Keywords: Risk adjustment , SQL, Databricks, claims

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $60,756 - $101,254. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Benefits: Caring For Your Family and Your Career

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
  
  
  

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Information Technology

• Industries

  Hospitals and Health Care

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