Job Information
Village Practice Management Company, LLC DBA VillageMD Senior Analyst, Risk Adjustment in Berkeley Heights, New Jersey
Operate as a cross-market analytical consultant to internal stakeholders focusing on our Medicare Advantage risk adjustment activity and supplemental submission process. Develop operational dashboards helping drive risk adjustment initiatives across all major payers and markets. Support ad hoc analyses for market leaders providing insights critical to employer success. Perform data cleansing to identify erroneous data and initiate corrections needed. Collaborate with other teams in analytics to develop and implement databases, processes and other strategies that optimize efficiency and quality. Develop Tableau dashboards. Establish initial logic and data sources for reconciling different data sources to the outbound submission and queued data. Resolve errors arising in the supplement submission for enhancing the accuracy and completeness of supplemental process. Review production logic versus suspect logic of the Hierarchical Condition Categories (HCCs), identifying and sizing gaps for potential revenue impact. Utilize various skills and technologies including, but not limited to: SAS, SQL, R, SPSS, Risk Adjustment Processing System (RAPS), 837/5010 files, MAO-001/ MAO-002/ MAO-004 files file formats, Facets. Position may telecommute from anywhere in the U.S.VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.This position requires at least a Master’s degree in Statistics, Mathematics, or a closely related field and at least three (3) years of experience in healthcare data analysis (any title) performing analysis for risk adjustment, creating dashboards, performing Hierarchical Condition Categories (HCC) reconciliation, improving existing processes and codes, and utilizing SAS, SQL, Risk Adjustment Processing System (RAPS), 837/5010 files, MAO-001/MAO-002/MAO-004 files file formats, and Facets. Position may telecommute from anywhere in the U.S.