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Data Analyst - Risk Adjustment



Company Description

At PopHealthCare, our mission is simple - to lead the effort in reimagining how healthcare is delivered. We are bold innovators, dedicated to making a difference and we hire wicked smart people!



Job Description

At PopHealthCare, our mission is simple - to lead the effort in reimagining how healthcare is delivered. We are bold innovators, dedicated to making a difference and we hire wicked smart people! We need a sharp and nimble Data Analyst - Risk Adjustment! This is a remote full-time position.


Job Summary: PopHealthCare is seeking a highly-skilled Data Analyst to support its Risk Adjustment data analysis and programming business requirements. We are looking for a talented, industrious analyst who shows initiative and creativity and can support associated business processes as necessary. This is a multi-faceted job that requires the ability to work on more than one project at a time. The ideal candidate will have experience and/or technical skills in one or more of the areas identified below.


Essential Job Functions:

  • Support all risk adjustment file management and reporting activities
  • Develop programs using SQL that create and analyze large data sets
  • Filter and “clean” data by creating and maintaining reports to improve data submission accuracy
  • Apply various analytic tools to determine financial trends, utilization, cost-shifting, and identify potential issues in healthcare data



Qualifications

Minimum Skill Set:

  • Working knowledge of healthcare data, including medical and pharmacy claims, CPT and ICD coding, and the claims adjudication process
  • Ability to develop new programs using SQL, creating and analyzing data sets
  • Ability to clean and transform data into proprietary data specifications
  • Ability to work independently as well as contribute to knowledge-sharing within a team environment
  • Bachelor's degree from an accredited institution or equivalent
  • Advanced knowledge of SQL or SAS (Base SAS or SAS Enterprise Guide)
  • Experience with large data sets in a data warehouse environment
  • Advanced understanding of Excel, including VLOOKUP, as well as pivot tables
  • Ability to communicate effectively and work well in a team-oriented environment


Preferred Skill Set:

  • All elements of the Minimum and Standard Skill Sets as well as the following:
  • Master's degree from an accredited institution with a concentration in Actuarial Sciences, Applied Mathematics or Statistics
  • Experience with the CMS HCC models for ACA or Medicare
  • Analytical work experience within the healthcare industry
  • Working knowledge of SQL Server, PowerBI, Python, or R
  • Working knowledge/experience with EDI files and transactions

PopHealthCare is an equal opportunity/equal access employer fully committed to achieving a diverse workforce.



Additional Information

All your information will be kept confidential according to EEO guidelines.

Before you apply, please check if any restrictions apply in terms of time zone or country.

This job has a geo-restriction in place:  USA Only.

PopHealthCare, LLC

This job listing is archived
Category Data
Job type Full-time
Hiring from USA Only
Date Posted 7mths ago

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