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Kompaniyadagi ish o‘rinlari

Senior Risk Adjustment Solutions Analyst - Remote, United States

Advantmed is seeking a senior analyst to improve healthcare data quality, Medicare Advantage analytics, SQL reporting, and risk adjustment revenue performance.

USAmerika Qo‘shma ShtatlariMasofaviyTo‘liq stavkaSeniorTalab Qilinadigan Til: inglizchaBiznes tahlilchisi
MS SQL ServerSQL

Tavsif

  • Assess Medicare Advantage and ACA Risk Adjustment performance to uncover RAF improvement and revenue optimization opportunities
  • Apply expertise in CMS-HCC, RxHCC, Medicare Risk Adjustment methodologies, and industry practices
  • Review operational and financial metrics and produce data-informed recommendations
  • Contribute to client initiatives, business reviews, and executive presentations
  • Analyze, cleanse, transform, reconcile, and validate large healthcare datasets from varied sources
  • Analyze Claims, Encounters, Eligibility, Pharmacy, Medical Record Review (MRR), and Health Assessment data
  • Use detailed analysis to identify trends, anomalies, and improvement opportunities
  • Investigate root causes and recommend corrective actions that strengthen data integrity and operational performance
  • Work extensively with CMS sources, including MMR, MOR, and other Medicare Advantage datasets
  • Assist with Risk Adjustment reconciliation, forecasting, and financial impact analysis
  • Create operational reports, scorecards, ad hoc analyses, and executive dashboards
  • Convert complex analytical results into actionable business recommendations
  • Build, optimize, and troubleshoot complex SQL queries, stored procedures, and data extraction workflows
  • Debug existing reporting and analytical scripts
  • Partner with business, operations, technology, and analytics teams to deliver scalable solutions
  • Contribute to automation, process improvement, and operational excellence initiatives

Talablar

  • Bachelor's degree in Healthcare, Statistics, Computer Science, Engineering, Business Analytics, or a related field
  • At least 5 years of healthcare data analytics experience, including data mining, mapping, transformation, validation, and reporting
  • At least 3 years of hands-on experience with Medicare Advantage and/or ACA Risk Adjustment
  • At least 3 years of experience as a Healthcare Data Analyst
  • At least 3 years of advanced SQL development experience
  • Strong knowledge of Medicare Advantage and ACA Risk Adjustment programs
  • Strong knowledge of CMS-HCC and RxHCC models
  • Strong knowledge of Medical Record Review (MRR) and Health Assessment processes
  • Strong knowledge of Claims, Encounter, Eligibility, and Pharmacy data
  • Strong knowledge of CMS data files, including MMR and MOR
  • Strong knowledge of the complete Risk Adjustment lifecycle
  • Strong knowledge of HEDIS and healthcare quality measures
  • Advanced SQL and Microsoft SQL Server skills
  • Experience with SQL Server Management Studio (SSMS)
  • Experience with data mapping, reconciliation, and validation
  • Experience with root cause analysis and data quality management
  • Experience producing ad hoc reports and extracting data
  • Strong analytical and problem-solving skills
  • Excellent communication and presentation skills
  • Experience working directly with clients and executive stakeholders
  • Ability to manage multiple priorities independently in a fast-paced environment

Imtiyozlar

  • Medical, dental, and vision health care plan
  • Annual performance bonus
  • 401(k) or IRA retirement plan
  • Basic, voluntary, and AD&D life insurance
  • Paid vacation, sick leave, and public holidays
  • Maternity and paternity family leave
  • Short-term and long-term disability coverage
  • Work-from-home arrangement
  • Wellness resources

O‘xshash ish o‘rinlari

Advocate Aurora Health

Human Resources Internship

Advocate Aurora Health
Sog‘liqni saqlashTibbiy sug‘urta
USAmerika Qo‘shma ShtatlariALAlabamaAKAlyaskaAZArizonaFLFloridaIDAydahoILIllinoysIAAyovaKSKanzasKYKentukkiLALuizianaMEMenMIMichiganMSMissisipiMOMissuriMTMontanaNENebraskaNVNevadaNHNyu-HempshirNMNyu-MeksikoNCShimoliy KarolinaNDShimoliy DakotaOHOgayoOKOklaxomaPAPensilvaniyaSCJanubiy KarolinaSDJanubiy DakotaTNTennessiTXTexasUTYutaVAVirjiniyaWVG‘arbiy VirjiniyaWIViskonsinWYVayoming
21 $ / soat
MasofaviyAmaliyotBoshlang‘ich darajaTalab Qilinadigan Til: inglizchaInson resurslari

Support recruiting, onboarding, employee engagement, and HR operations at Advocate Aurora Health. Build practical experience with HR systems, reporting, and process improvement in a remote internship.

Ochish
Johnson & Johnson

Director, Patient and Customer Experience – Johnson & Johnson, Singapore

Johnson & Johnson
H1B vizasi homiysiFarmatsevtika mahsulotlariSog‘liqni saqlashTibbiy sug‘urta
SGSingapurGibridTo‘liq stavkaYetakchiTalab Qilinadigan Til: inglizchaMijozlarni qo‘llab-quvvatlash

Lead Johnson & Johnson’s APAC patient experience, patient support and commercial AI strategy from Singapore. Drive regional customer experience adoption, market execution and cross-functional healthcare innovation.

Ochish