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Data Analyst - Healthcare

Company: Cara Staffing, Inc
Location: Newark
Posted on: November 18, 2021

Job Description:

Job DescriptionAnalyst, Risk Adjustment ProgramsJob Summary: Perform analytical studies related to Risk Adjustment. Assist in implementing the RA under ACA. Coordinate with Medicare and Medicaid risk adjustment programs.Responsibilities: The primary responsibility is to perform risk adjustment analytical studies that involve manipulations of large amounts of data; apply advanced programming techniques to streamline the analysis. Conduct gap analysis and data collection and validation. Analyze enrollment and claims data for patterns and trends to identify opportunity to improve documentation and coding.Identify and implement improvements to the Edge Server data. Coordinate with IT and other departments involved in running Edge Server as well as all other mandatory aspects of the 3R's.Coordinate the work of vendors in identifying and managing chart retrievals. Track vendor progress in meeting deadlines, reporting accurate and complete data.Coordinate the work on government audit of risk adjustment data (RADV Audit).Coordinate provider education and member outreach efforts as related to risk adjustment.Forecast RA payments and receivables and create reports for senior leadership.Knowledge: Project management skills.Expertise with statistical software tools in order to perform data manipulation and analysisComputer skills: Excel (including pivot tables), Access (including VBA),Excellent knowledge of SAS and SQL is a must.Knowledge of Informatica software is a plusEducation/ExperienceBA/BS in Mathematics, Statistics, Computer Science, Actuarial Science or other strong analytical fieldExperience with manipulating large amounts of clinical and medical claims data while working in health care industry, insurance or related field.Knowledge of risk adjustment programs for Medicare/Medicaid, or risk mitigation programs under ACA, is a plus.Strong analytical skills; experience with relational database and techniques.Strong written and oral communication skills

Keywords: Cara Staffing, Inc, Newark , Data Analyst - Healthcare, Healthcare , Newark, New Jersey

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