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Senior Data Analyst, Risk Adjustment at Veradigm

Senior Data Analyst, Risk Adjustment

@

Veradigm

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Posted on: 
August 11, 2023
Status: 
Expired
Views:
5

Summary of the Senior Data Analyst, Risk Adjustment job at Veradigm

Veradigm is hiring a Senior Data Analyst, Risk Adjustment with 3 - 5 years of experience. Based in United States - Remote and with Remote ways of working. The expected salary range for this role is $82,058 - $106,675
About Veradigm

This is Veradigm: Real-world insights with the power to improve real-world health and healthcare.

Senior Data Analyst, Risk Adjustment job description

The Senior Risk Adjustment Analyst will assist our organization as a subject-matter-expert in Medicare Advantage and Affordable Care Act (ACA) Risk Adjustment by developing requirements for new analytics and data products, creating customer financial calculations and projections, and researching customer questions regarding their risk adjustment performance.

Essential Functions

  • Develop business cases and requirements for new products and current product enhancements that will benefit our customers risk adjustment goals.
  • Lead customer requests for ad hoc reporting or research.
  • Own customer financial improvement modeling (examples include: Mid Year Payment, Final Year Payment, Transfer Payment).
  • Lead research initiatives to monitor our internal algorithm performance over time and recommend future enhancements.
  • Collaborate with clinicians in outcomes, algorithm performance, and new product development.
  • Provide training and guidance to internal and external customers on all facets of the Risk Adjustment process, from initial data capture at point-of-care, through acceptance to CMS, and successfully validated through audit.
  • Research and maintain awareness of CMS regulatory guidance and changes, providing expert interpretation for impacts to products and customers.
Senior Data Analyst, Risk Adjustment job requirements

Job Requirements

  • Bachelor’s degree in actuarial science, Math, Statistics, or in a related field of study
  • 3 to 5 years of experience analyzing and interpreting Medicare Advantage or Affordable Care Act Risk Adjustment data
  • Experience supporting the development of scalable analytic and reporting solutions
  • Up to 10% travel may be required

Knowledge, Skills And Abilities

  • Extensive experience in healthcare industry, with a focus on Risk Adjustment
  • Experience with MA/ACA Risk Scoring methodology, including familiarity with condition categories (HCC)
  • Experience with actuarial or financial modeling concepts
  • Experience interacting with large amounts of healthcare data; directly with the following CMS files (MMR, MOR, MAO-004, MAO-002, EDGE RARSD, EDGE RATEE)
  • Experience working with clinical classification such as diagnoses (ICD), procedures (HCPCS, CPT) and claims processing
  • Experience working with data to and from submission systems (RAPS, EDPS, Edge), including background on filtering logic for each system
  • Experience with MA mid-year and final year projections (MYRA, FYRA) and/or ACA transfer payments
  • Advance knowledge of SAS and experience with SQL
  • Working knowledge of statistics with ability/interest to become proficient
  • Proven technical, analytical, detail oriented, and problem solving
  • Strong written and verbal communication
  • Professional and interpersonal
  • Self-initiative and leadership
  • Ability to work within a team environment
  • Ability to interface with both external and internal personnel at all levels.
What we offer at Veradigm

In compliance with the Equal Pay for Equal Work Act we are disclosing the compensation range for roles that could be performed in the required city/states (California, Colorado, New York City and Washington State).

Pay Range

$82,058—$106,675.50 USD

Please mention “I found this job at DataAnalyst.com!” in your application, it will help us offer you more opportunities

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Average data analyst salary in the Healthcare industry is $97,890.
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Veradigm

Veradigm

is hiring

Senior Data Analyst, Risk Adjustment

Website:
Posted on: 
June 24, 2024

About Our Company

This is Veradigm: Real-world insights with the power to improve real-world health and healthcare.

Job Description & Responsibilities

The Senior Risk Adjustment Analyst will assist our organization as a subject-matter-expert in Medicare Advantage and Affordable Care Act (ACA) Risk Adjustment by developing requirements for new analytics and data products, creating customer financial calculations and projections, and researching customer questions regarding their risk adjustment performance.

Essential Functions

  • Develop business cases and requirements for new products and current product enhancements that will benefit our customers risk adjustment goals.
  • Lead customer requests for ad hoc reporting or research.
  • Own customer financial improvement modeling (examples include: Mid Year Payment, Final Year Payment, Transfer Payment).
  • Lead research initiatives to monitor our internal algorithm performance over time and recommend future enhancements.
  • Collaborate with clinicians in outcomes, algorithm performance, and new product development.
  • Provide training and guidance to internal and external customers on all facets of the Risk Adjustment process, from initial data capture at point-of-care, through acceptance to CMS, and successfully validated through audit.
  • Research and maintain awareness of CMS regulatory guidance and changes, providing expert interpretation for impacts to products and customers.

Requirements

Job Requirements

  • Bachelor’s degree in actuarial science, Math, Statistics, or in a related field of study
  • 3 to 5 years of experience analyzing and interpreting Medicare Advantage or Affordable Care Act Risk Adjustment data
  • Experience supporting the development of scalable analytic and reporting solutions
  • Up to 10% travel may be required

Knowledge, Skills And Abilities

  • Extensive experience in healthcare industry, with a focus on Risk Adjustment
  • Experience with MA/ACA Risk Scoring methodology, including familiarity with condition categories (HCC)
  • Experience with actuarial or financial modeling concepts
  • Experience interacting with large amounts of healthcare data; directly with the following CMS files (MMR, MOR, MAO-004, MAO-002, EDGE RARSD, EDGE RATEE)
  • Experience working with clinical classification such as diagnoses (ICD), procedures (HCPCS, CPT) and claims processing
  • Experience working with data to and from submission systems (RAPS, EDPS, Edge), including background on filtering logic for each system
  • Experience with MA mid-year and final year projections (MYRA, FYRA) and/or ACA transfer payments
  • Advance knowledge of SAS and experience with SQL
  • Working knowledge of statistics with ability/interest to become proficient
  • Proven technical, analytical, detail oriented, and problem solving
  • Strong written and verbal communication
  • Professional and interpersonal
  • Self-initiative and leadership
  • Ability to work within a team environment
  • Ability to interface with both external and internal personnel at all levels.

What we offer

In compliance with the Equal Pay for Equal Work Act we are disclosing the compensation range for roles that could be performed in the required city/states (California, Colorado, New York City and Washington State).

Pay Range

$82,058—$106,675.50 USD

Apply now

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