Risk Adjustment Data Analyst, Remote



IT, Data Science
Atlanta, GA, USA
Posted on Thursday, May 2, 2024
If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
As a Data Analyst specializing in Risk Adjustment in Value Based Care, you will play a crucial role in analyzing and interpreting healthcare data to ensure accurate risk adjustment models and methodologies. Your primary responsibilities will include gathering, cleaning, and analyzing data related to patient demographics, diagnoses, procedures, and other relevant healthcare metrics. You will collaborate with cross-functional teams to identify trends, patterns, and anomalies in the data, and provide actionable insights to improve risk adjustment processes and outcomes. Additionally, you will contribute to the development and refinement of risk adjustment algorithms and predictive models to optimize reimbursement accuracy for healthcare payers and providers.

Primary Duties:

  • Data Collection and Preparation:
  • Extract and aggregate healthcare data from various sources, including electronic health records (EHRs), claims databases, and administrative systems.
  • Clean and preprocess data to ensure accuracy, completeness, and consistency for analysis.
  • Perform data validation and quality assurance checks to identify and correct errors or inconsistencies.
  • Model Development and Validation:
  • Collaborate with actuaries, statisticians, and other team members to develop and refine risk adjustment models and algorithms.
  • Validate models using historical data and statistical techniques to ensure predictive accuracy and reliability.
  • Continuously monitor and evaluate model performance and recommend adjustments or enhancements as needed.
  • Cross-Functional Collaboration:
  • Work closely with healthcare providers, payers, and other stakeholders to understand business requirements and data needs.
  • Collaborate with IT professionals to enhance data infrastructure, implement data governance policies, and streamline data processes.
  • Provide subject matter expertise on risk adjustment methodologies and regulations to support business decisions and strategic initiatives.
  • Data Analysis and Interpretation:
  • Utilize statistical techniques and analytical tools to analyze healthcare data and identify trends, patterns, and correlations.
  • Conduct risk score calculations and trend analysis to assess the accuracy of risk adjustment methodologies.
  • Generate reports, dashboards, and visualizations to communicate findings and insights to stakeholders effectively.

Minimum Qualifications:

  • Bachelor's or Master's degree in Statistics, Mathematics, Computer Science, Healthcare Informatics, or related field.
  • 3+ years of experience in healthcare data analysis, preferably in risk adjustment or healthcare analytics.
  • Proficiency in statistical analysis tools such as R, Python, SAS, or SQL.
  • Familiarity with healthcare coding systems (e.g., ICD-10, CPT, HCPCS) and risk adjustment models (e.g., HCC, ACG, CMS-HCC).
  • Strong analytical, problem-solving, and critical-thinking skills.
  • Excellent communication and presentation abilities, with the ability to translate complex technical concepts into clear and actionable insights.
  • Ability to work effectively both independently and collaboratively in a fast-paced, dynamic environment.

Preferred Key Skills and Abilities:

  • Experience with machine learning algorithms and predictive modeling techniques.
  • Knowledge of healthcare regulations and compliance requirements related to risk adjustment, such as CMS Hierarchical Condition Categories (HCC) coding guidelines.
  • Certification in healthcare analytics (e.g., Certified Health Data Analyst - CHDA) or related field.

Physical Requirements:

  • Ability to travel up to 10% of the time, as needed
Who We Are:
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of payers, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives, and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
What Does This Mean for You?
At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents, and domestic partners Robust time off plan 21 days of PTO in your first year 2 Paid Volunteer Days & 11 paid holidays
12 weeks paid Parental Leave for all new parents
6 weeks paid sabbatical after 6 years of service
Educational Assistant Program & Clinical Employee Reimbursement Program
401(K) with up to 4% match
Stock options
And much more!
At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop, and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance, and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
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