Senior Risk Adjustment Analyst - Health Plan - Remote

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond.  As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community.  Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day.  Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.
 

Key Outcomes:

• Examines and performs data management analyses and develops and presents a variety of performance results in addition to other pertinent communication
• Transfers data into meaningful, professional, and easy to understand formats for leadership
• Reviews data, develops recommendations and reviews findings with senior leadership
• Analyzes and extracts data from the Enterprise Data Warehouse (EDW) and other sources to report to internal and external customers
• Designs, develops, tests, documents, and maintains database queries for ad hoc reporting used in complex conceptual analyses for all departments within Risk Adjustment Operations
• Develops systematic reporting processes and procedures to ensure timely delivery of daily, weekly, monthly, annual, and ad hoc reports to support key departmental and organizational initiatives
• Serves as the liaison between departments including IT and Finance for all Risk Adjustment reporting needs
• Troubleshoots errors and data inconsistencies and coordinates resolutions to issues as directed by self, staff, and various levels of leadership
• Takes a lead role in the tracking of progress and activities of key initiatives 
• Plans and assists with testing processes and activities including new report or analytics methodology validation
• Responsible for documenting and updating changes to workflow, training plans, policies and procedures and ensure redundancy in these knowledge areas with other analytics resources
• Provides analytic mentorship and guidance to operational departments related to revenue optimization
• Participates in the development of risk adjustment operational and strategic planning processes
• Subject matter expert in CMS HCC Risk Adjustment modeling
• May lead vendor research, software installation, configuration support, and interface development applications as needed
• Maintains and is expert user of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding
• Recommends tools and methodologies that can be deployed at the organizational level, to the departments and with external partner

Education/Experience:

• Bachelor’s degree in Economics, Finance, Statistics, Mathematics, Actuarial Sciences, or other quantitative discipline; Master’s degree preferred
• Minimum of 5 years’ experience related to reporting and analysis of health care data ideally in the areas of managed care, health care delivery, code sets, and/or reimbursement
• Experience in developing cost-benefit and ROI analyses
• In compliance with MPHC’s Department of Defense government contract, any/all persons hired for this position will need to verify their US citizenship and complete the required employment eligibility verification upon hire. ​

We are an equal opportunity/affirmative action employer.

Do you have a question about careers at Martin’s Point Health Care? Contact us at: jobinquiries@martinspoint.org