Sentara Health is looking for a Senior Risk Adjustment Data Analyst  to join our team!

This position is 100% Remote, but candidates must have a current residence in one of the following East Coast states, or be willing to relocate: Delaware, Florida, Georgia, Maine, Maryland, New Hampshire, North Carolina, Pennsylvania, South Carolina, Virginia , West Virginia

The Senior Risk Adjustment Data Analyst provides data analysis supports to Sentara Health Plans’ Revenue Management team, affiliated internal departments, and external vendor partners. The Senor RA Analyst supports in designing and implementing processes and solutions utilizing a wide variety of data sets to resolve business challenges in relation to optimizing Risk Adjustment premium revenue. The senior analyst uses a combinations of data/text mining, analysis, reporting, predictive and risk modeling to support informed business decisions. This requires complete understanding of claims, pharmacy, lab, network utilization, and cost containment data. Additionally, familiarity with external data sources including Medicare, Medicaid, and Health Exchange data files is required.

The Senior RA Data Analyst is required to show independent thinking. The senior analyst assists in identifying business challenges, support development of processes to address the challenges, and metrics to track and monitor business processes. This requires a high level of understanding of Centers for Medicare and Medicaid (CMS), Health and Human Services (HHS), or Virginia Department of Medical Assistance (VA-DMAS) Risk Adjustment programs. The Senior RA Data Analyst must

Serve as SME for standard analytic suites using EDP data sources for membership data and claims.Create and manage tables in the revenue management sandbox.Design table layouts and collaborate with the enterprise data team to develop new tables.Partner with architecture teams to build new and necessary data sources.Project Involvement: Collaborate with vendors on risk adjustment initiatives.Created necessary reports for business and regulatory use.Automated existing reports to improve efficiency.Developed and maintained dashboards for data visualization.
 Education

Bachelor's Degree in Mathematics, Statistics, Finance, Economics, Computer Science, or related

Certification/Licensure No specific certification or licensure requirements

Experience3 - 5 years in data analysis, predictive modeling, Medical Economics or relatedAdvanced Knowledge of SQL AND databricks is required.Ability to break out complex technical processes and explain to non-technical audiences Understanding of Prospective and Retrospective Risk Adjustment Interventions preferredExcellent Oral and Written Communication Skills Problem Solving Consultative Engagement Skills

Keywords: Risk adjustment , SQL, Databricks, claims

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $60,756 - $101,254.  Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is:$60,756.80-$101,254.40. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.