Risk Score Data Analyst

Mass General Brigham•Somerville, MA

1d•$63,648 - $92,570•Remote

About The Position

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more. This is an ideal candidate for a mid-career changer hoping to get into healthcare or an entry-level candidate with some experience in analytics. This role is responsible for providing primary analytic and operational support to the Risk Score Management program with the objective of improving the accuracy of member risk profiles. This analyst will develop and produce reports based on risk adjustment data from several data sources, work with both internal and external departments to identify opportunities for risk score improvement, and manage multiple risk score projects. The position will be responsible for targeted member tracking for medical record audits and outreach, vendor management, and provider engagement. This analyst may also be required at times to lead analytic projects with minimal supervision and work cross-functionally with various departments such as Actuarial, Finance, Medical Economics, and Clinical.

Requirements

Bachelor's Degree required
Data analysis experience preferred
Strong analytical skills, including basic SQL, SAS, or advanced Excel.
Excellent verbal and written communication skills.
Creative, flexible, self-directed, and self-motivated with sound judgment and critical thinking.
Accountable for delivering high-quality work.
Organizational and project management skills to manage projects effectively.
Interest in government healthcare programs (Medicare, Medicaid).
Strong in drafting briefings and presentations for internal and external use.

Responsibilities

Creates and produces risk adjustment analyses for the Risk Score department, senior leadership, and internal and external customers.
Analyze claims and membership data to identify trends and patterns using Excel/SQL/SAS, etc.
Completes ad-hoc analyses to support internal and external customers.
Evaluates data quality of internal and external datasets.
Participates in various departmental projects operationally and analytically such as vendor-assisted chart reviews, audits and in-home medical assessments.
Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with internal and external customers and gains their trust and respect.
Tracks deliverables and action items across internal departments and vendors to keep projects moving.
Monitors CMS and MassHealth risk adjustment policy and guidance and summarizes operational implications for the department.