What are the responsibilities and job description for the Risk Data Analyst position at Engage Partners Inc.?
We're Hiring: Risk Adjustment Data Analyst III (Remote)
We are only able to accept applications from candidates residing in NY, NJ, PA, DE, or CT.
Are you passionate about healthcare analytics and risk adjustment data? We're looking for an experienced Risk Adjustment Data Analyst III to join our team. This is a full-time, remote opportunity for someone with a strong background in managed care, claims data, and healthcare analytics.
About the Role
As a Risk Adjustment Data Analyst III, you’ll be a key player in ensuring accurate and timely risk adjustment data submission and validation. You'll oversee complex projects, collaborate with stakeholders, and contribute to program improvements to meet regulatory guidelines.
Key Responsibilities
- Lead data submission, validation, and monitoring within regulator guidelines.
- Perform risk score calculations, analyze encounter data, and support chart review programs and audits.
- Investigate encounter errors, conduct root cause analysis, and recommend solutions based on data trends.
- Develop technical documentation and implement system specifications.
- Collaborate with leadership on predictive modeling and advanced data analysis.
- Mentor junior analysts and review their work.
- Conduct gap analyses, data validation, and support process improvements.
- Create reports and insights to optimize risk adjustment outcomes.
- Stay updated on industry changes, including CMS regulations and payment models.
Qualifications
- Education: Bachelor’s degree in Computer Science, Data Science, or a related analytical field preferred; Master’s degree is a plus.
- Experience: At least 5 years of programming or analytics experience, in healthcare or insurance. Familiarity with clinical claims data and diagnostic coding practices is a plus.
- Technical Skills: Proficiency in SAS, SQL, or Oracle is required; R and Python knowledge is a bonus. Advanced Excel skills (pivot tables) are essential.
- Knowledge: Understanding of Medicare/Medicaid risk adjustment or ACA risk mitigation programs is highly desirable.
- Certifications: SAS, Oracle, or SQL certifications are a plus.
What We’re Looking For
- Exceptional analytical, research, and problem-solving skills.
- Ability to manage large clinical and claims datasets.
- Strong communication skills and attention to detail.
- A proactive team player who can juggle multiple priorities effectively.
If you're ready to make a meaningful impact in healthcare analytics, we’d love to hear from you!
Apply now to join our dynamic team and help shape the future of risk adjustment.