Sr Healthcare Risk Adjustment Analyst - Remote

Allscripts; Houston (TX); Remote; USD 60,000 - 100,000; Full time

Job summary

Join a forward-thinking company in the healthcare analytics sector, where you can leverage your analytical skills to make a significant impact on healthcare outcomes. This role offers a unique opportunity for career advancement and growth, working collaboratively in a supportive environment. You'll be responsible for developing business cases, leading customer reporting initiatives, and providing training on risk adjustment processes. With a comprehensive benefits package and a focus on professional development, this position promises to be both rewarding and impactful. If you're ready to contribute to data-driven solutions that enhance healthcare, this is the perfect opportunity for you.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Company-Paid Life Insurance

Retirement Savings Options

Supportive Work Environment

Career Advancement Opportunities

Qualifications

• 3 to 5 years of experience analyzing Medicare Advantage and ACA data.
• Proven technical and analytical skills in healthcare analytics.

Responsibilities

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

Skills

Analytical Skills

Problem-Solving Skills

Detail-Oriented

Technical Skills

Education

Bachelor’s degree in Actuarial Science

Bachelor’s degree in Math

Bachelor’s degree in Statistics

Tools

SAS

SQL

Snowflake

Job description

Employer Industry: Healthcare Analytics

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
- Company-paid life insurance and retirement savings options
- Supportive and collaborative work environment focused on professional development
- Chance to make a positive impact on healthcare through data-driven solutions
- Up to 10% travel may be required, adding variety to the role

What to Expect (Job Responsibilities):
- Develop business cases and requirements for new products and enhancements to meet customer risk adjustment goals
- Lead customer requests for ad hoc reporting or research initiatives
- Own customer financial improvement modeling, including Mid-Year Payment and Final Year Payment
- Collaborate with clinicians on outcomes, algorithm performance, and new product development
- 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
- 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
- Extensive experience in the healthcare industry, particularly in Risk Adjustment
- Proven technical, analytical, detail-oriented, and problem-solving skills

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 clinical classification such as ICD diagnoses and claims processing
- Experience interacting with large amounts of healthcare data, particularly with CMS files
- Knowledge of Snowflake is preferred

#HealthcareAnalytics #RiskAdjustment #CareerOpportunity #DataDrivenSolutions #HealthcareIndustry

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