Sr Healthcare Risk Adjustment Analyst - Remote

Allscripts; Atlanta (GA); Remote; USD 60,000 - 95,000; Full time

Job summary

An established industry player in healthcare analytics is seeking a dedicated professional to enhance patient outcomes through data-driven solutions. This role offers the chance to develop impactful business cases and lead critical reporting initiatives while collaborating with a talented team. The ideal candidate will possess a strong analytical background and exceptional communication skills, enabling them to thrive in a supportive environment. With opportunities for career advancement and a comprehensive benefits package, this position is perfect for those looking to make a meaningful impact in the healthcare sector.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Paid Life Insurance

Retirement Savings

Career Advancement Opportunities

Qualifications

• 3 to 5 years of experience analyzing Medicare Advantage data.
• Strong written and verbal communication skills are essential.

Responsibilities

• Develop business cases for new products to support customer goals.
• Lead customer requests for reporting and research initiatives.

Skills

Data Analysis

Communication Skills

Team Collaboration

Education

Bachelor’s degree in Actuarial Science

Bachelor’s degree in Math

Bachelor’s degree in Statistics

Tools

SAS

SQL

Job description

Employer Industry: Healthcare Analytics Solutions

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Comprehensive compensation and benefits package, including medical, dental, and vision insurance, paid life insurance, and retirement savings
- Engage in meaningful work that addresses healthcare challenges and improves patient outcomes
- Collaborate with a talented team of professionals in a supportive and dynamic environment
- Up to 10% travel may be required for this position

What to Expect (Job Responsibilities):
- Develop business cases and requirements for new products and enhancements to support customer risk adjustment goals
- Lead customer requests for ad hoc reporting or research initiatives
- Oversee customer financial improvement modeling, including Mid-Year Payment and Final Year Payment
- Conduct research to monitor internal algorithm performance and recommend future enhancements
- Provide training and guidance on the Risk Adjustment process to internal and external customers

What is Required (Qualifications):
- Bachelor’s degree in Actuarial Science, Math, Statistics, or a related field of study
- 3 to 5 years of experience analyzing and interpreting Medicare Advantage, ACA, or Medicaid Risk Adjustment data
- Experience supporting the development of scalable analytic and reporting solutions
- Strong written and verbal communication skills with exceptional interpersonal abilities
- Ability to work within a team environment

How to Stand Out (Preferred Qualifications):
- Experience with MA mid-year and final year projections and/or ACA transfer payments
- Advanced knowledge of SAS and SQL
- Familiarity with healthcare data interaction and CMS files (MMR, MOR, MAO-004, MAO-002, etc.)
- Experience with clinical classification, including diagnoses and claims processing
- Knowledge of statistics with a willingness to become proficient

#HealthcareAnalytics #RiskAdjustment #CareerOpportunity #HealthcareIndustry #DataDrivenSolutions

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