Centrum Health

Centrum Health

Risk Adjustment Analyst

Doral, Florida, United States

Sponsorship not specifiedDetected 8 days ago
ScalaSQLDatabricksData VisualizationStatisticsExcelPatient CareResearchPublic Speaking

About the role

  • By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.
  • We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally.
  • SCOPE OF ROLE The Risk Adjustment and Analytics Team is working to push boundaries to redefine Risk Adjustment and Quality Analytics in a Value-Based Care Setting.

Responsibilities

  • Proactively collaborate and interact with business stakeholders across the organization to understand analytics needs, develop plans to address those needs, and deliver analytics to meet those needs.
  • Own the data. You are responsible for accurate presentation of your data elements, so ensuring data integrity is paramount.
  • Create data processes that are consistent, repeatable, and scalable.
  • Conduct Quarterly Reconciliations to identify dropped HCCs and prepare supplemental data submission files according to payor partner specifications.
  • The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk

Nice to have

  • ​ Bachelor's degree is required.
  • Comprehensive understanding of risk adjustment and quality programs across all government-regulated lines of business, including Marketplace, Medicaid, and Medicare programs.
  • Five (5) or more years of hands-on SQL code development is required, including expertise with programming languages like Scala or Python.
  • Three (3) or more years of analytics experience (Required)
  • Two (2) or more years of Power BI experience (Required)
  • Experience with Databricks (Preferred)
  • Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models
  • Familiarity with HEDIS and MSSP Quality Reporting

Benefits

  • NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care.
  • NeueHealth delivers clinical care to health consumers through our owned clinics - Centrum Health and Premier Medical - as well as unique partnerships with affiliated providers across the country.
  • Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.
  • Using SQL code, mine data on medical spend, clinical data and population health data and derive meaningful insights to improve operations such as trends, correlations and patterns.

Company info

  • NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.
  • NeueHealth delivers clinical care to health consumers through our owned clinics - Centrum Health and Premier Medical - as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.
  • The Risk Adjustment and Analytics Team is working to push boundaries to redefine Risk Adjustment and Quality Analytics in a Value-Based Care Setting. The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk Adjustment and Quality Data and Dashboards for our entire NeueHealth Portfolio: ACA, Medicare, ACO REACH, MSSP, and Medicaid. The Risk Adjustment and Quality Analyst will be responsible for working both independently and collaboratively between multiple departments such as Analytics, Risk Adjustment and Quality, Medical Economics, & Clinical Operations.
  • The Risk Adjustment and Analytics Team is working to push boundaries to redefine Risk Adjustment and Quality Analytics in a Value-Based Care Setting.
  • The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk Adjustment and Quality Data and Dashboards for our entire NeueHealth Portfolio: ACA, Medicare, ACO REACH, MSSP, and Medicaid.
  • The Risk Adjustment and Quality Analyst will be responsible for working both independently and collaboratively between multiple departments such as Analytics, Risk Adjustment and Quality, Medical Economics, & Clinical Operations.
  • This is an onsite position in Doral, FL.
  • Thoroughly analyze data, quickly identify relevant information, and transform it into a meaningful output. Conduct thoughtful presentations, online or in person, to stakeholders with actionable findings for improvement.
  • Provide concise data reports and clear data visualizations for executive level reporting through Power BI, Excel and other tools used by the organization.
  • Three (3) or more years of experience in healthcare field dealing with claims/utilization as it pertains to Risk Adjustment and Quality.
Apply directly at Centrum Health →Create a free account for alerts like thisView Centrum Health immigration profile

This listing is sourced directly from Centrum Health's careers page and normalized into a canonical job model.