Employer Industry: Healthcare Analytics Solutions

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Comprehensive compensation and benefits package, including medical, dental, and vision insurance, paid life insurance, and retirement savings
- Engage in meaningful work that addresses healthcare challenges and improves patient outcomes
- Collaborate with a talented team of professionals in a supportive and dynamic environment
- Up to 10% travel may be required for this position

What to Expect (Job Responsibilities):
- Develop business cases and requirements for new products and enhancements to support customer risk adjustment goals
- Lead customer requests for ad hoc reporting or research initiatives
- Oversee customer financial improvement modeling, including Mid-Year Payment and Final Year Payment
- Conduct research to monitor internal algorithm performance and recommend future enhancements
- Provide training and guidance on the Risk Adjustment process to internal and external customers

What is Required (Qualifications):
- Bachelor’s degree in Actuarial Science, Math, Statistics, or a related field of study
- 3 to 5 years of experience analyzing and interpreting Medicare Advantage, ACA, or Medicaid Risk Adjustment data
- Experience supporting the development of scalable analytic and reporting solutions
- Strong written and verbal communication skills with exceptional interpersonal abilities
- Ability to work within a team environment

How to Stand Out (Preferred Qualifications):
- Experience with MA mid-year and final year projections and/or ACA transfer payments
- Advanced knowledge of SAS and SQL
- Familiarity with healthcare data interaction and CMS files (MMR, MOR, MAO-004, MAO-002, etc.)
- Experience with clinical classification, including diagnoses and claims processing
- Knowledge of statistics with a willingness to become proficient

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