Risk Adjustment Analyst

Columbus, OH 43085

Post Date: 05/02/2018 Job ID: 27099 Category: Information Technology / IT


Position Purpose:
  • Responsible for advanced and predictive data analytics using big data and data science technology for healthcare innovation and outcomes.
  • Perform analysis using data science techniques on structured and unstructured data sets, and develop algorithms for Risk Adjustment.


Position Responsibilities:
  • Design, develop and maintain risk adjustment data models.
  • Prepare risk score projections to estimate future payments.
  • Researches and reports on relevant regulatory and process changes impacting risk adjustment and financial performance.
  • Tracks and monitors encounter data submissions and supplemental information to state and federal systems.
  • Manage relationship and oversight of various risk adjustment vendors.
  • Design and construct analysis tools that extract, and analyze data and store analytical results in an appropriate format for business needs.
  • Conduct exploratory data analysis from complex data sources and build key data sets to support company's mission.
  • Evaluate and design experiments to monitor key metrics and identify improvement opportunities.
  • Develop mathematical and statistical models to distinguish relevant content or events and recognize patterns.
  • Participate in presentations and communicate results of analysis and findings.
  • Participate in the design of automated, operational analytics processes to achieve scale and durability of analysis processes.
  • Validate and measure the outcomes of health management programs using SAS, R and other tools, to include provider data, claims data, membership data.
  • Manage multiple projects as assigned.
  • Assist with training Data Analysts.

 

Qualifications:
  • Master's degree in Statistics, Mathematics, Computer Science, Informatics, Econometrics, Engineering, Experimental Science with 3+ years of experience or Bachelor s degree and 5+ years of quantitative analysis experience in data science capabilities including data mining, predictive modeling, machine learning, statistical modeling, large scale data acquisition, transformation, and structured and unstructured data analysis.
  • Experience with database technologies, including Oracle, SAP, DB2, Teradata, MS SQL Server, SAP HANA, MySQL.
  • Healthcare & Risk Adjustment experience strongly preferred.
  • SAS and Micro Strategy experience preferred.

For more information on this position, please call 877-782-3334.

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