Healthcare Data Analyst, Remote

Primary Duties:

• Data Collection and Preparation:
• Extract and aggregate healthcare data from various sources, including electronic health records (EHRs), claims databases, and administrative systems.
• Clean and preprocess data to ensure accuracy, completeness, and consistency for analysis.
• Perform data validation and quality assurance checks to identify and correct errors or inconsistencies.
• Model Development and Validation:
• Collaborate with actuaries, statisticians, and other team members to develop and refine risk adjustment models and algorithms.
• Validate models using historical data and statistical techniques to ensure predictive accuracy and reliability.
• Continuously monitor and evaluate model performance and recommend adjustments or enhancements as needed.
• Cross-Functional Collaboration:
• Work closely with healthcare providers, payers, and other stakeholders to understand business requirements and data needs.
• Collaborate with IT professionals to enhance data infrastructure, implement data governance policies, and streamline data processes.
• Provide subject matter expertise on risk adjustment methodologies and regulations to support business decisions and strategic initiatives.
• Data Analysis and Interpretation:
• Utilize statistical techniques and analytical tools to analyze healthcare data and identify trends, patterns, and correlations.
• Conduct risk score calculations and trend analysis to assess the accuracy of risk adjustment methodologies.
• Generate reports, dashboards, and visualizations to communicate findings and insights to stakeholders effectively.

Minimum Qualifications:

• Bachelor's or Master's degree in Statistics, Mathematics, Computer Science, Healthcare Informatics, or related field.
• 3+ years of experience in healthcare data analysis, preferably in risk adjustment or healthcare analytics.
• Proficiency in statistical analysis tools such as R, Python, SAS, or SQL.
• Familiarity with healthcare coding systems (e.g., ICD-10, CPT, HCPCS) and risk adjustment models (e.g., HCC, ACG, CMS-HCC).
• Strong analytical, problem-solving, and critical-thinking skills.
• Excellent communication and presentation abilities, with the ability to translate complex technical concepts into clear and actionable insights.
• Ability to work effectively both independently and collaboratively in a fast-paced, dynamic environment.

Preferred Key Skills and Abilities:

• Experience with machine learning algorithms and predictive modeling techniques.
• Knowledge of healthcare regulations and compliance requirements related to risk adjustment, such as CMS Hierarchical Condition Categories (HCC) coding guidelines.
• Certification in healthcare analytics (e.g., Certified Health Data Analyst - CHDA) or related field.

Physical Requirements:

• Ability to travel up to 10% of the time, as needed