Medicare Risk Adjustment Data Analyst

Summary

The job is for a Medicare Risk Adjustment Analyst at Reveleer, a healthcare data and analytics company. The role involves data analysis, model development, data wrangling, collaboration, and stakeholder communication in a remote setting.

Requirements

• Demonstrated ability to process complex data sets in a SQL/SAS environment to generate actionable insights
• Experience with healthcare data. Preferably health plan claims, membership and risk adjustment data
• Strong analytical skills and critical thinking. Intellectual curiosity and flexibility. Ability to independently break down complex problems into discrete, solvable pieces
• Desire to take ownership of complex projects and the responsibility of guiding those projects from ideation through completion
• Demonstrated ability to build trust with business stakeholders, manage the relationship and socialize insights effectively
• Be able to communicate analytical insights with a variety of business stakeholders across different technical levels (including senior leaders)
• Self-motivated and be able to work independently

Responsibilities

• Ideate and build data pipelines that facilitate process improvement and ROI analytics for Reveleer risk adjustment products
• Develop risk adjustment models to calculate RAF scores, generate financial projections and identify opportunities
• Wrangle large data sets from health plans, CMS and internal Reveleer processes. Develop scalable solutions to ingest, synthesize and utilize these data sets to solve business problems
• Serve as the subject matter expert for multiple areas of risk adjustment, health plan data structures and medical record review operations
• Collaborate with product managers, data scientists and data engineers, in an Agile and technology-driven environment
• Present in front of internal and external stakeholders. Support sales and operations teams

Preferred Qualifications

• At least 3 years of work experience in Risk Adjustment analytics, preferable for multiple lines of business
• Experience with data visualization software (e.g., Looker, Tableau, Power BI)
• Actuarial background
• Demonstrated experience with data science techniques and development of predictive models
• Experience with NLP methods
• Experience in a healthcare environment
• Experience of processing JSON files
• Experience of cloud (AWS preferred)

Benefits

• Competitive pay
• Medical, Dental and Vision benefits including HSA/FSA
• 401k with Employer Match
• 100% paid short term and long-term disability insurance
• PTO plan and 10 paid company holidays