About the position
The Quality, Stars, and Risk Adjustment Analytics team is hiring a lead data analyst with deep experience in risk adjustment. This person will support the Director of Risk Adjustment by monitoring and reporting on risk adjustment KPIs, delivering insights for prospective and retrospective risk adjustment operational decisions, and working independently to improve process and data integrity. In addition, this person will work directly with vendors that supply additional data and reporting. Note: We are looking for an experienced professional to live and work remotely from within the greater Baltimore/Washington metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities.
Responsibilities
- Engages in data exploration using various programming languages (reading and writing code), requiring advanced knowledge of multiple database structures.
- Collect, analyze, and interpret data to glean insights, and develop business appropriate recommendations.
- Serve as an expert resource supporting data questions and issues from stakeholders and driving to resolution.
- Research and analyze data flow across complex data ecosystem including operational and analytical data platforms.
- Manage the collection of business and technical requirements from stakeholders to deliver data driven solution.
- Produces and reviews technical documentation that is consistent with professional standards.
- Lead in the design, development, validation and delivery of data to provide insight into business decisions.
- Act as a mentor to all team members.
Requirements
- Bachelor's Degree in Data Science, Mathematics, Computer Science, Statistics, Business or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
- 8 years experience in a progressively responsible analytical/quantitative role.
Nice-to-haves
- Experience in healthcare industry and deep understanding of Medicare risk adjustment (clinical, submission cycle, and financial experience).
- Strong experience with SQL, Power BI, and Excel.
- Skill with PowerPoint and experience presenting to a diverse set of stakeholders.
- Strong project management skills and ability to manage multiple and diverse stakeholders and leadership roles.
- Knowledge of claims data as found in back-end data warehouses.
- Experience with Fabric or Alteryx is a plus but not required.
Benefits
- Comprehensive benefits package
- Various incentive programs/plans
- 401k contribution programs/plans
