Senior Risk Adjustment Data Analyst

Summary

Join the Central California Alliance for Health as a Senior Risk Adjustment Data Analyst and perform complex analytical data mining and reporting. You will lead initiatives, provide program support, and perform project management related to data gathering and analysis. The ideal candidate is well-versed in risk adjustment methodologies, particularly within the Medicare space, and proficient in SQL. This role requires strong collaboration skills and the ability to work effectively with various organizational teams. The position offers a hybrid work environment and a competitive compensation package. The Alliance is an award-winning regional Medi-Cal managed care plan serving over 418,000 members.

Requirements

• Well versed in risk adjustment methodologies, particularly within the Medicare space
• Familiarity with risk adjustment models and their impact on plan performance and payment
• Proficiency in SQL, and an ability to analyze and translate complex healthcare data into meaningful and actionable insights, in addition to general reporting
• Experience with data visualization tools to present insights clearly and effectively
• Self-directed and proactive, with the ability to manage priorities and drive projects forward
• Strong collaborator who can work effectively with organizational teams, including IT, finance, operations, clinical and compliance teams
• Knowledge of: Quantitative data analysis methodologies and analytical tools related to risk adjustment reporting and analysis
• Data modeling techniques and business analytical and data mining tools, including SQL, and data visualization tools, such as Tableau
• Medicare program and related regulations
• Medicare (Hierarchical Condition Categories) risk adjustment models
• Methods and techniques of developing and delivering data management strategies that support contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations
• Ability to: Collect, interpret, and evaluate data, detect patterns, brainstorm solutions, consider multiple factors when making decisions, and project consequences of recommendations
• Perform technical and non-technical troubleshooting and diagnose and resolve complex problems, including problems that may have multiple variables and may not have obvious solutions
• Act as a technical resource, provide guidance related to area of assignment, and explain related regulations, processes, and programs
• Work collaboratively and productively with diverse project teams in order to achieve efficient and timely solutions
• Education and Experience: Bachelor’s degree in Finance, Business, Information Technology, or a related field
• A minimum of five years of experience performing health care finance reporting and analytics, including a minimum of three years of experience working in a Medicare environment (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying

Responsibilities

• Reporting to the Risk Adjustment Director, this position will perform complex analytical data mining and reporting in support of the Risk Adjustment Department
• You will also lead initiatives, provide program support, and perform project management related to data gathering and analysis as well as act as a subject matter expert and resource regarding risk adjustment data

Preferred Qualifications

Medicaid/Medi-Cal experience a plus

Benefits

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations