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Sr. Risk Adjustment Data Modeler

Company: Vatica Health
Location: Atlanta
Posted on: January 16, 2022

Job Description:

We are looking for an experienced Sr. Risk Adjustment Data Modeler with health plan or actuarial background to develop risk adjustment calculations, processes, and perform a broad range of pertinent analysis. This position will be responsible for analysis of Medicare, ACA, & Medicaid populations. To succeed in this role, you should be analytical, resourceful, and have a complete understanding of Medicare Advantage ACA, Medicaid, Risk Adjustment models, and concepts. You should also be an excellent communicator who is able to tell the story behind raw data to non-technical audiences.
Develop and maintain risk adjustment calculation engines using appropriate data sources and software
Create standard Risk Adjustment analysis and metrics, such as same -store analysis, incremental lift, gap analysis, and HCC/code recapture.
Interpret CMS Advance Notices, and Federal Register documentation
Analyze/Clean/Load/Stage payer data from disparate sources into centralized data marts
Delve into data to discover discrepancies and patterns
Present and explain information analysis in an accessible way to internal stakeholders and external partners
Collaborate with management and internal teams to implement and evaluate improvements.

Expert knowledge of CMS-HCC, HHS-HCC and risk adjust models
Familiarity or working knowledge of state-specific CDPS Medicaid models.
BSc/BA in Health Informatics, Statistics, Mathematics, Actuarial Science, or a related field
2-3+ years proven experience as a Healthcare Data Analyst (Emphasis on Risk Adjustment Calculations)
2-3+ years of experience in data analysis and BI Software (Tableau, Power BI, SSRS)
3+ years' experience writing SQL preference for MS T-SQL, SQL Server, and SSMS
Experienced in executing SAS-based Risk Adjustment modeling desired
Ability to work in a fast-paced environment with minimal direction
Knowledge of Extract, Transform and Load (ETL) processes
Experience with Enterprise Data Warehouse (EDW) and data management systems
Excellent analytical and communication skills
Outstanding organizational and problem-solving aptitude



Competitive salary based on your experience and skills - we believe the top talent deserves the top dollar
Bonus Potential (based on role and is discretionary) - if you go above and beyond, you should be rewarded
401k plans- we want to empower you to prepare for your future
Room for growth and advancement- we love our employees and want to develop within

Good Health
Comprehensive Medical, Dental, and Vision insurance plans
Tax-free Dependent Care Account
Life insurance, short-term, and long-term disability

Excellent PTO policy (everyone deserves a vacation now and then)
Great work-life balance environment- We believe family comes first!
Strong supportive teams- There is always a helping hand when you need it

Keywords: Vatica Health, Atlanta , Sr. Risk Adjustment Data Modeler, Other , Atlanta, Georgia

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