02 Nov
Risk Adjustment Data Analyst
New Jersey, Newark , 07193 Newark USA

Vacancy expired!

Job Title: Risk Adjustment Data Analyst Job Location: Newark, NJ(Hybrid) Job Type: Full Time Job Summary: The Data Analyst leads the technology process for the end-to-end Risk Adjustment Processing System (RAPS) and Encounter Data Processing System (EDPS) data flow and works within key regulator guidelines for acceptable data submission. Using SQL and SAS programs lead the gathering of data for submissions Risk Adjustment. As the senior analyst of data will be responsible for leading the manipulation of large amounts of data and managing data submission with minimum supervision Responsibilities: Lead the coordination with IT and other departments involved in running Edge Server and/or Risk Adjustment data submission, as well as all other mandatory aspects of Risk Adjustment and Risk Adjustment Data Validation (RADV) Oversees the creation of technical documents and high-level solution designs Recommends best practices for delivering business solutions Leads the development, testing, and implementation of system specifications Oversee the coordination with IT and other departments involved in running Edge Server and/or Risk Adjustment data submission, as well as all other mandatory aspects of Risk Adjustment and Risk Adjustment Data Validation (RADV) Interact with RA leadership to create predictive models using information obtained from data mining or analysis Lead, manage, develop and train less-experienced staff by providing guidance to other analysts and quality review their work Conduct gap analysis, data collection and validation related to Risk Adjustment activities Performs other functions as assigned by management Knowledge: Requires knowledge of user-oriented programming languages including SQL and/or RAMIS Requires knowledge related to clinical care (i.e. nursing, social work) Prefers candidates with knowledge of Plan products and files Requires strong analytical abilities and the ability to report findings accurately Requires excellent verbal and written communication skills Requires strong interpersonal skills and the ability to interact with all management levels Requires the ability to utilize logic in problem-solving Requires the ability to coordinate projects Education/Experience: BA/BS in Mathematics, Statistics, Computer Science, Actuarial Science, or other strong analytical field required; MS or MA is a plus IT experience is strongly preferred Actuarial experience and passing Actuarial exams is a plus Requires 7 years experience with analytics in health care, insurance, or related field; clinical and medical claims data and disease diagnostic coding practice a plus Knowledge of risk adjustment programs for Medicare/Medicaid, or risk mitigation programs under ACA, is a plus Strong analytical skills; experience with relational databases and techniques Strong problem-solving skills Strong written and oral communication skills Expertise with statistical software tools in order to perform data manipulation and analysis

Vacancy expired!


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