Senior Risk Adjustment Data Analyst

Role Overview

• Take ownership of complex data workflows, build scalable analytics pipelines, and contribute to productizing insights using modern data tools such as SQL, dbt, Airflow, Snowflake, and Databricks
• Analyze large datasets to identify trends, patterns, and insights about coding output to enhance productivity and quality, and turn those needs into actionable reporting
• Provide real-time data insights to business on-demand through ad-hoc queries
• Use your technical skills and experience to streamline ad-hoc analyses into reusable data products where possible
• Collect, interpret, and aggregate data from multiple data sources for supporting risk adjustment medical record coding and quality processes
• Design, develop, test, and deploy reporting to support risk adjustment business users’ needs
• Automate reporting and analytics when appropriate to make more scalable across customers and deliverable to a broader set of stakeholders
• Identify trends in the reporting and work to partner with the teams to improve productivity and quality.
• Run various risk adjustment models for Medicare Advantage, Medicaid or ACA to forecast patient risk scores and return on investment based on historical data and project variables
• Work closely with cross-functional teams, including clients, to understand business needs, and determine the right methodology for analysis and assumptions to provide data-driven insights into program performance and partnerships
• Create clear and concise reports to communicate findings and insights to both technical and non-technical stakeholders
• Stay abreast of industry trends, new technologies, and methodologies to enhance the team's analytical capabilities
• Help guide, mentor and train other junior analysts in support of their direct manager

Requirements

• Experienced (5+ years or more) in data analysis, database technologies (Oracle/MS SQL Server, Snowflake, Databricks)
• Deep understanding of and experience in Risk Adjustment (MA, ACA and MD) business analytics with knowledge of different risk models including HCC, RxHCC, HHS-HCC and CDPS
• Intermediate proficiency in SQL (advanced analytic queries), Python (data manipulation and automation, streamlit, etc.), spreadsheets and BI tools
• Experience analyzing risk adjustment data for trends, disease/diagnosis prevalence and hierarchy
• Experience managing data flows for chart retrieval, RA coding, HEDIS abstraction and quality
• Ability to build, architect and deliver robust customer facing and internal reports
• Experience in building queries to collect and interpret raw data from databases to support risk adjustment coding and medical record
• Experience in using business intelligence, data visualization, query, analytic and statistical software to build solutions, perform analysis and interpret data (SSRS, Power BI, Tableau, Looker, Sigma)
• Strong problem-solving skills with the ability to think critically and provide data-driven solutions
• Expertise in the data cleaning, preprocessing, manipulation, integration, processing and interrogation of large datasets
• Exceptional initiative and ability to solve problems independently, seek help when needed, and take ownership when navigating ambiguity
• Excellent communication skills
• Well-developed time management skills and demonstrable experience of prioritizing work to meet tight deadlines for client deliverables

Tech Stack

• Airflow
• MS SQL Server
• Oracle
• Python
• SQL
• Tableau

Benefits

• Health insurance
• 401(k) matching
• Paid time off
• Flexible work arrangements
• Professional development opportunities