Sr Analyst, Healthcare Analytics - Risk Adjustment (REMOTE)

Lensa; Covington (KY); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company in healthcare analytics is seeking a Sr. Analyst to join their Risk Adjustment team. This remote position involves analyzing complex healthcare data, developing performance reports, and providing strategic insights to improve healthcare interventions. Ideal candidates will have a strong background in data analysis, SQL, and financial metrics, with a Bachelor's degree in Finance, Economics, or Computer Science. Competitive salary and benefits offered.

Qualifications

• 5-7 years of complex database management experience.
• Healthcare experience in analyzing financial metrics.

Responsibilities

• Research and analyze complex healthcare claims data.
• Develop and present Risk Adjustment intervention ROI reports.
• Perform financial analysis to support healthcare management decisions.

Skills

Data Analysis

SQL

Financial Analysis

Attention to Detail

Programming Knowledge

Education

Bachelor's Degree in Finance

Bachelor's Degree in Economics

Bachelor's Degree in Computer Science

Tools

Power BI

Tableau

Databricks

SQL Server

Job description

Sr Analyst, Healthcare Analytics - Risk Adjustment (REMOTE)

1 day ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Job Description

This Sr. Analyst, Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis, and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare intervention program performance. Develops and presents Risk Adjustment intervention ROI, incremental conditions captured, and other program performance reports including forecasts and makes recommendations based on relevant findings. Performs Health Plan strategic analysis and planning and coordinates across business units on Risk Adjustment Program Valuation and Strategic/Scoreable Action Items (SAIs) to meet business needs. Performs analysis across multiple states and lines of business (Medicare, Medicaid, Marketplace ACA).

Knowledge/Skills/Abilities

• Compiling and organizing health care data using Databricks, Spark SQL, Notebooks, Workflows, Repositories, SQL Server Stored Procedures, SQL Server Integration Services (SSIS), and other analytic/programming tools as needed
• Reporting includes Risk Adjustment program performance metrics, risk score and revenue impact, tracking of strategic/scorable action items, forecasts, and deep dives to drive financial improvement
• Ownership with root cause analysis to ensure data integrity and minimize discrepancies
• Create databases and dashboards for monitoring, tracking, and trending; apply automation where appropriate
• Analysis and forecasting of risk adjustment program values
• Proficiency in running risk models for CMS Medicare Advantage, HHS Commercial ACA, CDPS Medicaid, and others
• Strong attention to detail and knowledge of data structures and programming
• Perform financial analysis to support healthcare management decisions
• Apply best practices in data storage and sharing
• Convert data into insights for strategic investments
• Develop reports and analyses for senior management, communicating results effectively
• Gather and document report requirements, using peer reviews and end-user input to reduce errors
• Exercise judgment independently, consult experts as needed, and utilize resources effectively
• Manage multiple projects and deliver results on time in a fast-paced, changing environment

Job Qualifications

Required Education

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

Required Experience

• 5-7 years of complex database and data management responsibilities
• 5-7 years of experience in quantifying, measuring, and analyzing financial/performance metrics
• Healthcare experience in analyzing financial and utilization metrics
• Advanced SQL knowledge
• Proficiency in Excel and visualization tools like Power BI or Tableau

Preferred Education

Bachelor's Degree in Finance, Economics, Math, or Computer Science

Preferred Experience

• Experience in Medical Economics and knowledge of performance indicators
• Investigative skills in risk adjustment initiatives, risk score lift, and program value
• Analysis and forecasting of program value and population trends
• Experience as Healthcare Analyst I or Financial/Accounting Analyst I
• Experience with multiple data systems and models, including BI tools

To all current Molina employees: Please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. We are an Equal Opportunity Employer (EOE) M/F/D/V.

#PJCorp

Pay Range: $77,969 - $155,508 / ANNUAL

• Actual compensation may vary based on location, experience, education, and skills.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Health Care Provider
• Industries: IT Services and IT Consulting

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