Sr. Data Analyst/Risk Adjustment

ESRhealthcare•Nyc, NY

4d•Remote

About The Position

The Risk Adjustment Sr Data Analyst is an experienced analyst possessing a deep understanding of the Risk Adjustment business domain and is skilled at data modeling and analysis and identifying and communicating insights to stakeholders. You will be joining a team that is focused on ensuring the work we do for our customers is of the highest quality and yields positive outcomes. To achieve this, you will leverage a wide array of data and technology for analytics and partner with various internal and external stakeholders to understand business objectives and deliver results. As a Sr. Data Analyst, you will: Take ownership of complex data workflows, build scalable analytics pipelines, and contribute to productizing insights using modern data tools such as SQL, dbt, Airflow, Snowflake, and Databricks Analyze large datasets to identify trends, patterns, and insights about coding output to enhance productivity and quality, and turn those needs into actionable reporting Provide real-time data insights to business on-demand through ad-hoc queries Use your technical skills and experience to streamline ad-hoc analyses into reusable data products where possible Collect, interpret, and aggregate data from multiple data sources for supporting risk adjustment medical record coding and quality processes Design, develop, test, and deploy reporting to support risk adjustment business users needs Automate reporting and analytics when appropriate to make more scalable across customers and deliverable to a broader set of stakeholders Identify trends in the reporting and work to partner with the teams to improve productivity and quality. Run various risk adjustment models for Medicare Advantage, Medicaid or ACA to forecast patient risk scores and return on investment based on historical data and project variables Work closely with cross-functional teams, including clients, to understand business needs, and determine the right methodology for analysis and assumptions to provide data-driven insights into program performance and partnerships Create clear and concise reports to communicate findings and insights to both technical and non-technical stakeholders Stay abreast of industry trends, new technologies, and methodologies to enhance the team's analytical capabilities Help guide, mentor and train other junior analysts in support of their direct manager

Requirements

Experienced (5+ years or more) in data analysis, database technologies (Oracle/MS SQL Server, Snowflake, Databricks), SQL queries, MS Excel, Python, etc.
Deep understanding of and experience in Risk Adjustment (MA, ACA and MD) business analytics with knowledge of different risk models including HCC, RxHCC, HHS-HCC and CDPS
Intermediate proficiency in SQL (advanced analytic queries), Python (data manipulation and automation, streamlit, etc.), spreadsheets and BI tools
Experience analyzing risk adjustment data for trends, disease/diagnosis prevalence and hierarchy
Experience managing data flows for chart retrieval, RA coding, HEDIS abstraction and quality
Ability to build, architect and deliver robust customer facing and internal reports
Experience in building queries to collect and interpret raw data from databases to support risk adjustment coding and medical record
Experience in using business intelligence, data visualization, query, analytic and statistical software to build solutions, perform analysis and interpret data (SSRS, Power BI, Tableau, Looker, Sigma)
Strong problem-solving skills with the ability to think critically and provide data-driven solutions
Expertise in the data cleaning, preprocessing, manipulation, integration, processing and interrogation of large datasets
Exceptional initiative and ability to solve problems independently, seek help when needed, and take ownership when navigating ambiguity
Excellent communication skills
Well-developed time management skills and demonstrable experience of prioritizing work to meet tight deadlines for client deliverables

Nice To Haves

An appreciation of the need for effective data privacy and security methods and an awareness of the relevant legislation
Experience with cloud services for storage and computing
Experience with machine learning algorithms
Knowledgeable in health plan operations and reporting

Responsibilities

Take ownership of complex data workflows, build scalable analytics pipelines, and contribute to productizing insights using modern data tools such as SQL, dbt, Airflow, Snowflake, and Databricks
Analyze large datasets to identify trends, patterns, and insights about coding output to enhance productivity and quality, and turn those needs into actionable reporting
Provide real-time data insights to business on-demand through ad-hoc queries
Use your technical skills and experience to streamline ad-hoc analyses into reusable data products where possible
Collect, interpret, and aggregate data from multiple data sources for supporting risk adjustment medical record coding and quality processes
Design, develop, test, and deploy reporting to support risk adjustment business users needs
Automate reporting and analytics when appropriate to make more scalable across customers and deliverable to a broader set of stakeholders
Identify trends in the reporting and work to partner with the teams to improve productivity and quality.
Run various risk adjustment models for Medicare Advantage, Medicaid or ACA to forecast patient risk scores and return on investment based on historical data and project variables
Work closely with cross-functional teams, including clients, to understand business needs, and determine the right methodology for analysis and assumptions to provide data-driven insights into program performance and partnerships
Create clear and concise reports to communicate findings and insights to both technical and non-technical stakeholders
Stay abreast of industry trends, new technologies, and methodologies to enhance the team's analytical capabilities
Help guide, mentor and train other junior analysts in support of their direct manager