Sr Risk Adjustment Analyst - Remote

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

Job summary

An established industry player in healthcare analytics is seeking a talented professional to join their team. This role offers the chance to develop impactful solutions that enhance risk adjustment performance while fostering a supportive work environment. The ideal candidate will leverage their analytical skills and healthcare industry experience to drive significant improvements. With opportunities for career advancement and a comprehensive benefits package, this position is perfect for those looking to make a meaningful impact in the field. Join a forward-thinking organization that values collaboration and innovation.

Benefits

Comprehensive medical insurance

Dental insurance

Vision insurance

Career advancement opportunities

Collaborative work environment

Qualifications

• 3 to 5 years of experience analyzing Medicare Advantage, ACA, or Medicaid data.
• Experience in developing scalable analytic and reporting solutions.

Responsibilities

• Develop business cases and requirements for new products.
• Lead customer requests for ad hoc reporting or research.
• Provide training on the Risk Adjustment process.

Skills

SAS

SQL

Data Analysis

Risk Adjustment

Education

Bachelor's degree in Actuarial Science

Bachelor's degree in Math

Bachelor's degree in Statistics

Tools

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
- Supportive and collaborative work environment
- Chance to make a significant impact on healthcare analytics and risk adjustment performance
- Up to 10% travel may be required for 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
- Own customer financial improvement modeling, including Mid-Year Payment and Final Year Payment
- Collaborate with clinicians on outcomes and new product development
- Provide training and guidance on the Risk Adjustment process from data capture to CMS acceptance

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
- Extensive experience in the healthcare industry with a focus on Risk Adjustment
- Advanced knowledge of SAS and SQL

How to Stand Out (Preferred Qualifications):
- Familiarity with MA/ACA Risk Scoring methodology, including condition categories (HCC, RxHCC)
- Experience with actuarial or financial modeling concepts
- Experience with clinical classification such as diagnoses (ICD) and procedures (HCPCS, CPT)
- Background in data submission systems (RAPS, EDPS, Edge)
- Experience with Snowflake

#HealthcareAnalytics #RiskAdjustment #CareerGrowth #HealthcareJobs #DataDrivenSolutions

We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.