Medicare Risk Adjustment Data Analyst

Job Number: 5263

Workplace Type: Fully Remote

Position Title: Risk Adjustment Analyst

External Description:

POSITION SUMMARY:
The Risk Adjustment Analyst is responsible for providing and maintaining Risk Adjustment reporting, monitoring program performance to the organizations KPIs, identify and recommend areas of reporting improvement, and developing and communicating clear action plans to drive processes to both internally and externally.

GENERAL DUTIES/RESPONSIBILITIES (MAY INCLUDE BUT ARE NOT LIMITED TO):
• Maintaining current reporting packages for internal and external clients as well as develop new reports of moderate complexity
• Ad-Hoc analysis of various programs or projects
• Executes standard processes / programs to accurate and timely data is provided to internal and external clients
• Recommends and implements new or modified reporting methods and procedures to improve business processes, report content and completeness of information
• Serves as the liaison between departments, markets and IT for all Risk Adjustment reporting needs
• Troubleshoots all errors and data inconsistencies and coordinates resolutions to issues as directed by self, staff, regional market leadership, and corporate management
• Attends network meetings as needed to review reports and deliverables on an as needed basis.
• Understands how to communicate difficult and sensitive information tactfully. Proactively manages changes in project scope, identifies any potential crisis or issues and devises contingency plans to mitigate concerns
• Responsible for documenting and updating changes to workflow, training plans, policies and procedures, as directed
• Performs all other related duties as assigned

SUPERVISORY RESPONSIBILITIES:
N/A

MINIMUM REQUIREMENTS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Minimum Experience:
a. 2+ years of decision support, data analysis, or healthcare operations experience (if no degree)
2. Education/Licensure:
a. Bachelor's degree in Actuarial Science, Mathematics or Data Science
3. Other:
a. Possession of strong analytical/statistical skills used in evaluating and analyzing data
b. Advanced PC skills (PowerPoint, Word, Outlook)
c. Advanced Excel skills (pivot tables, reporting)
d. Intermediate SQL skills
e. Preferred:
i. 2+ years of Healthcare or risk adjustment experience
ii. Advanced SQL skills
iii. Experience using Power BI
4. Work Environment:
a. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

ESSENTIAL PHYSICAL FUNCTIONS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

City: Remote-US

State: California

Location City: Remote-US

Location State: California

Community / Marketing Title: Medicare Risk Adjustment Data Analyst

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].