Market Success analyst

ob Description

The following duties and responsibilities generally reflect the expectations of this position but are not intended to be exhaustive. 

• Diagnose & Debug escalations tied to data in the data lake, Minerva (our clinical platform), agilonhub and/or CORE 
• Design and Develop Risk Adjustment related reports in Sigma. 
• Develop debug scripts in SQL that is based on Medicare CMS Risk model. 
• Perform analysis and dashboarding activities relating to: risk score calculation, claims/encounters data submission, chart review programs and audits, and related performance metrics. 
• Calculate ROI analysis for various risk adjustment programs. 
• Analysis and reporting on CMS data such as MMR and MOR received through various health plans. 
• Communicate and collaborate with internal and external stakeholders on risk adjustment related analysis, knowledge, or both. 
• Generate target population list for retrospective and prospective programs. 
• Generate program files as per vendor data layout. 
• Stay updated and share knowledge on industry changes especially any changes on CMS side (changes like ICD10, EDS, Payment Model Changes) 

Qualifications: 

• 7 years of experience in Healthcare Analytics. 
• 2+ years working with Medicare Claims, MMR, MOR, and RAPs data 
• Experience with healthcare claims, enrollment, and pharmacy data is preferred. 
• Strong command on SQL Server (T-SQL), SSIS and SSRS, and Database design. BI /Looker/Tableau/Sigma experience would be a plus. 
• Understanding of Medicare Risk Adjustment Payment Model and Cycle including the knowledge base to calculate risk scores would be a plus. 
• BS in a quantitative discipline such as finance, economics, or mathematics desired. 
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