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Position: Risk Adjustment Business Intelligence Analyst (REMOTE NATIONWIDE) Position Summary: This position sits within the Risk Adjustment Department and analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers.
Identifies and interprets trends and patterns in datasets to locate influences and drive actionable insights.
Constructs forecasts, recommendations and strategic/tactical plans based on Risk Adjustment data and market knowledge.
Creates specifications for reports and analysis based on business needs and required or available data elements.
May provide consultation to users and lead cross-functional teams to address business issues.
May directly produce datasets and reports for analysis using system reporting tools.
You will be equally capable at delivering thoughtful analytics as you will be at communicating and presenting data to internal and external stakeholders.
This position will require someone that can think strategically and be innovative, work well across departments and able to deliver accurate and timely information under tight deadlines.
Your work will enable Risk Adjustment team members and leaders to manage our business.
This position will have no direct reports.
Lastly, this position will not only be performing analysis, creation of reporting, and deep dive data requests, but will be expected to have a seat at the table when these reports are being conceptualized.
Job Description: Key Roles & Responsibilities: Accurate and timely delivery of Risk Adjustment analysis, creation of reporting, population targeting for programs, and Ad Hoc requests Collaborative contributor that will partner with multiple departments to drive the delivery of requests, as well as, partner within the Risk Adjustment Team to help develop requirements Able to take complex datasets and provide simple, focused analysis to Risk Adjustment Team Transform common datasets into actionable lists to meet vendor, client, and/or internal stakeholder needs Help steward Risk Adjustment projects across the organization Read, interpret, and develop reporting & analysis from changes in CMS Policy as related to Risk Adjustment.
A yearly examination & subsequent report will be required to analyze the impact of such policy/program changes Supports ensuring the integrity and accuracy of Risk Adjustment data Assist with creation of Tableau, Excel, SQL, etc… reporting and dashboards Experience, Qualifications, & Education 5 plus years in a Health Plan, Vendor or Health System Operations performing similar functions Bachelor’s degree is preferred Understanding of Medicare Risk Adjustment (HCC) required, additional general understanding of Medicaid & Commercial Risk Adjustment preferred Excellent problem solving, issue resolution, and root cause analysis skills Self-Starter and able to work both collaboratively across teams and independently Comfortable dealing with ambiguity Experience creating and presenting client deliverables Consistent experience creating actionable reports and analysis from multiple data sources Working Conditions While performing the duties of this job, the employee works in normal office working conditions.
Disclaimer The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required.
The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.
Lumeris is an EEO/AA employer M/F/V/D.
Location: Addison, TX, Addison, TX, Ann Arbor, MI, Apollo Beach, FL, Arlington, TX, Atlanta, GA, Austin, TX, Baltimore, MD, Barrow, GA, Bartow, FL, Baton Rouge, LA, Boston, MA, Brandon, FL, Braselton, GA, Charlotte, NC, Chicago, IL, Clearwater, FL, Columbus, OH, Dade City, FL, Dallas, TX, Dayton, OH, Denver, CO, Detroit, MI, Durham, NC, Edison, NJ { 27 more} Time Type: Full time 06022021