Sr. Data Analyst, Risk Adjustment

Job Summary

Key Responsibilities/Duties – what you will be doing

Data Analysis

• Support program reporting by developing and maintaining program dashboards, reports and deliverables for internal leadership and external provider organizations
• Extract, transform and analyze health care data from various internal data systems (Oracle, SQL Server, and Teradata) using SAS and SQL knowledge to support risk adjustment initiatives
• Work with internal claims, provider, member data and external analytics vendors to independently perform opportunity analyses across business divisions, product lines and provider groups
• Support the program management team in reviewing data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management

Data Management

• Establish and manage data transfer methods with vendors, including working with IT to setup and manage secure file transfer sites for vendors that support our risk adjustment programs
• Manage all incoming data from program operations, perform quality checks and disseminate to various stakeholder groups as appropriate
• Maintain organized structure for all incoming data, operational reporting, and program communications. Develop and manage policies and procedures associated with these work efforts

Program Management

• Support the implementation, operations, and evaluation of risk adjustment programs across Point32Health’s Government business, support Commercial business as needed
• Coordinate program operations with various other internal departments, including select member referrals and/or grievances
• Support program close-out and evaluation of vendor and program performance for programs implemented to optimize risk score accuracy for the Government business and Commercial business as necessary

Project Management

• Provide implementation support for risk adjustment vendor implementation and operations related to key data deliverables and requirements
• Take ownership of key tasks associated with program operations such as managing operational and status updates, including but not limited to the collection, organization, and distribution of all incoming risk adjustment program data
• Create, compile and format presentations for a variety of audiences. This includes the supporting worksheets, graphics, supplemental documents

Administration

• Attend meetings, document key decisions, manage follow up actions as necessary
• Serve as department point of contact for various internal and external initiatives, including interdepartmental projects across Point32Health business lines
• Create and manage business policies and procedures and knowledge repositories for the department as needed

Qualifications – what you need to perform the job

EDUCATION, CERTIFICATION AND LICENSURE:

• Bachelor's degree required, preferably in related field such as health informatics, business analysis, IT, finance, decision modeling.

EXPERIENCE (minimum years required):

• Three to five years of experience in analytical roles in the health care or health insurance sector either for a health plan, provider group, healthcare IT / management consultancy or auditing firm.
• Understanding of claims systems, provider information, Medicaid/Medicare, and/or experience working with large data sets preferred.

SKILL REQUIREMENTS:

• Engaged, critical thinker, organized, detail-oriented, resourceful, and self-motivated
• Comfortable working with large data sets from disparate sources, and able to identify relevant patterns and trends
• Expertise in SAS Enterprise Guide/ SAS Base and SQL/ProcSQL (SAS certification preferred)
• Experience with database software and reporting tools such as SQL Server, Oracle, and Cognos
• Experience with Alteryx, Cloudera and Tableau is a plus
• Proficient in Microsoft Excel, PowerPoint, and Word
• Strong interpersonal and communication skills
• Ability to work collaboratively with both internal and external resources
• Ability to take responsibility, prioritize tasks and follow through to completion

Commitment to Diversity, Equity & Inclusion

Point32Health is committed to making diversity, equity, and inclusion part of everything we do—from product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

Scam alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_operations@point32health.org

This job has been posted by Ignyte AI on behalf of Point32Health. Ignyte AI is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of Ignyte AI not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.

Req ID: R8273