Sr Healthcare Risk Adjustment Analyst - Remote

Allscripts; Raleigh (NC); Remote; USD 60,000 - 95,000; Full time

Job summary

An established industry player in healthcare analytics is seeking a skilled professional to enhance risk adjustment processes. This role offers the opportunity to work with cutting-edge AI technologies and advanced data-driven solutions, fostering a collaborative environment that values diverse perspectives. Ideal candidates will possess a strong analytical background and experience in the healthcare sector, particularly with Medicare Advantage and Medicaid data. Join a dynamic organization that prioritizes career advancement and professional development, where your contributions will make a significant impact on the industry.

Benefits

Comprehensive compensation and benefits package

Medical, dental, and vision insurance

Career advancement opportunities

Collaborative work environment

Cutting-edge technology exposure

Qualifications

• 3-5 years of experience analyzing Medicare Advantage or Medicaid Risk Adjustment data.
• Strong written and verbal communication skills with exceptional interpersonal abilities.

Responsibilities

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

Skills

Data Analysis

Risk Adjustment

Communication Skills

Problem Solving

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

Why consider this job opportunity:
- Comprehensive compensation and benefits package, including medical, dental, and vision insurance
- Opportunity for career advancement and professional development within a dynamic organization
- Supportive and collaborative work environment that values diverse perspectives
- Chance to work with cutting-edge artificial intelligence technologies and advanced data-driven solutions
- 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 and research initiatives
- Own customer financial improvement modeling, including various payment calculations
- Monitor internal algorithm performance and recommend future enhancements
- Provide training and guidance on all aspects of the Risk Adjustment process

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 supporting the development of scalable analytic and reporting solutions
- Extensive experience in the healthcare industry with a focus on Risk Adjustment
- Strong written and verbal communication skills, with exceptional interpersonal abilities

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 CMS files and healthcare data processing systems
- Experience with clinical classification systems, such as ICD and HCPCS
- Curiosity and self-initiative in tackling complex problems

#HealthcareAnalytics #RiskAdjustment #DataDrivenSolutions #CareerDevelopment #DiversityandInclusion

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