Sr Healthcare Risk Adjustment Analyst - Remote

Allscripts; Philadelphia (Philadelphia County); Remote; USD 65,000 - 100,000; Full time

Job summary

An established industry player in healthcare analytics is seeking a skilled professional to drive impactful healthcare solutions through advanced data analysis. This role offers the opportunity to work with cutting-edge artificial intelligence technologies and contribute significantly to improving healthcare outcomes. With a focus on collaboration and innovation, you will develop business cases, lead reporting initiatives, and provide training on risk adjustment processes. Join a supportive work environment that values diverse perspectives and offers career advancement opportunities in a rapidly evolving field.

Benefits

Comprehensive compensation package

Medical insurance

Dental insurance

Vision insurance

Career advancement opportunities

Professional development support

Qualifications

• 3-5 years of experience analyzing Medicare Advantage or Medicaid Risk Adjustment data.
• Experience in developing scalable analytic and reporting solutions.

Responsibilities

• Develop business cases and requirements for new products to support customer goals.
• Collaborate with clinicians on outcomes and new product development.

Skills

Data Analysis

Risk Adjustment Knowledge

Analytical Skills

Communication 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:
- Comprehensive compensation and benefits package, including medical, dental, and vision insurance
- Opportunity for career advancement and professional development within the organization
- Engaging and supportive work environment that values diverse perspectives
- Work with cutting-edge artificial intelligence technologies to drive impactful healthcare solutions
- Chance to make a significant contribution to improving healthcare outcomes for various stakeholders

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
- Own financial improvement modeling for customers, including various payment types
- 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 Medicare Advantage, ACA, or Medicaid Risk Adjustment data
- Experience in developing scalable analytic and reporting solutions
- Up to 10% travel may be required
- Extensive knowledge of Risk Adjustment in the healthcare industry

How to Stand Out (Preferred Qualifications):
- Familiarity with MA/ACA Risk Scoring methodology and condition categories
- Experience with actuarial or financial modeling concepts
- Proficiency in SAS and SQL
- Background working with large healthcare data sets and CMS files
- Experience with Snowflake

#HealthcareAnalytics #RiskAdjustment #DataDrivenSolutions #CareerOpportunities #DiversityAndInclusion

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