The Risk Adjustment Data Analyst is an analytical role that is responsible for supporting the Risk Adjustment Department in strategic decision-making through the use of data analysis, interpretation and reporting.
Data Analysis and Analytical Report Development – 80%
• Use industry standard analytical software (e.g. SAS, SSRS, SQL Server, etc.) to develop and implement reports for internal and external stakeholders.
• Develop and implement advanced queries.
• Participate in the analysis of clinical, financial and quality data sets and communicate coding/auditing trends to Risk Adjustment leadership for the creation of innovative Risk Adjustment strategies
• Participate in the development and implementation of analytical processes that allow for predictive analytics, trend analyses, variation analyses, and provider profiling.
• Solve business problems through analysis and communicate the outcomes to internal and external stakeholders, business owners and senior management.
• Consult with internal and external stakeholders to develop business requirements for report development.
• Maintain proper documentation to support Standard Operating Procedures.
Ad-hoc Analysis and Reporting Support – 20%
• Provide support for ad -hoc clinical, financial, regulatory, pharmacy and operational informational requests.
• Prepare reports and supporting analysis for internal and external stakeholders to review trends, identify patterns in coding and billing, and improve both clinical and financial efficiency from a Risk Adjustment perspective.
• Act as a resource for other members of the department on business issues and identify ways to leverage data and reporting to solve problems identified by the team.
|Bachelor’s degree with 2 years’ experience in SAS/SQL along with some informatics, analytical processes and reporting development experience preferably in a healthcare setting or an equivalent combination of education and experience.
• Experience with analytical software and languages (SAS and SQL) required
• Experience with claims, clinical, and/or financial data preferred
• Experience with data interpretation, analysis and reporting preferred
• Knowledge of Risk Adjustment a plus
• Knowledge of managed care and health care claims a plus
• Excellent oral and written communication skills
• Ability to design, evaluate and interpret complex data sets
|Data Entry - Continually (5 1/2 - 8 hrs)
Hearing - Continually (5 1/2 - 8 hrs)
Seeing - Continually (5 1/2 - 8 hrs)
Sitting - Continually (5 1/2 - 8 hrs)
Talking - Frequently (2 1/2 - 5 1/2 hrs)