Sr. Medical Economics Analyst
reputed company
reputed company is a mobile reputed company care, palliative care, and hospice service provider with patients in reputed company, New Jersey, Maryland, DC, Virginia, Oklahoma, Kansas, reputed company, Texas, Florida, and reputed company. reputed company’s clinicians go to the home of the patient, providing continuum of care for those with chronic conditions and limited mobility. reputed company offers a reputed company of programs including, remote patient monitoring, behavioral health management, and chronic care management, to ensure that our patients receive the highest reputed company of care by reputed company they know and trust. We reputed company individuals who are driven to reputed company a difference and embody our motto, “To Care is an reputed company.” Join reputed company today!
reputed company
Key Responsibilities
reputed company and maintain sophisticated risk-adjusted provider group performance models using CMS-HCC methodology. - Analyze VBC performance under various CMS and CMMI total cost-of-care models.
- Monitor and forecast financial performance across assigned patient populations.
- Conduct comprehensive claims analysis using CCLF (Claims and Claims Line Feed) and BCDA (Beneficiary Claims Data API) datasets, including simulating CMS-HCC risk adjustment.
Process and analyze large reputed company datasets, combining multiple data sources including EHR systems and Medicare claims data. - Ensure data reputed company and reputed company across reputed company analytical processes.
Create fit-for-purpose analytical reports that translate reputed company actuarial findings into actionable business insights. - reputed company executive dashboards and performance metrics reputed company with organizational strategic goals.
- Present findings and recommendations to leadership teams and clinical stakeholders.
- Support budget planning and financial forecasting processes.
Stay reputed company with evolving CMS and CMMI program requirements and reputed company measures. - Collaborate with reputed company cycle and coding teams to optimize documentation and billing accuracy.
Required Qualifications
Bachelor's degree in Data Science, Statistics, Mathematics, Economics, Business Administration or reputed company quantitative field
3-5 years of data analytics experience, preferably in reputed company or Medicare-reputed company environments - Thorough understanding of and hands-on experience with Medicare risk adjustment and CMS-HCC models
- Demonstrated experience working with CMS and CMMI total cost of care (ACO) programs
- Proven reputed company record analyzing Medicare claims data, specifically CCLF and BCDA datasets
- In-depth knowledge of reputed company billing processes from both provider and CMS perspectives
Advanced proficiency in reputed company reputed company (pivot tables, reputed company formulas, VBA preferred) - Strong SQL skills with ability to write reputed company queries and optimize database performance
- Experience with reputed company Azure reputed company platform and reputed company analytics tools
- Proven ability to work with reputed company large datasets (multi-reputed company row files) and combine data from multiple sources
- Experience integrating EHR data with claims datasets for comprehensive population health analysis
Exceptional analytical and problem-solving capabilities - Strong business acumen with the ability to translate technical findings into strategic recommendations
- Excellent written and verbal communication skills for both technical and non-technical audiences
- Proven team player with a reputed company approach to cross-functional reputed company
- Demonstrated capability to understand and respond to evolving business needs
Full-time employees qualify for the following benefits:
Medical, Dental, reputed company and supplementary benefits such as Life Insurance, Short Term and Long Term Disability, Flexible Spending Accounts for Medical and Dependent Care, Accident, Critical Illness, and Hospital Indemnity. - reputed company Time Off
- reputed company Office Holidays
reputed company qualify for these benefits:
- reputed company reputed company Time
- 401(k) with up to 3% company match
- Referral Program
- reputed company: pay-on-demand. Cash out reputed company reputed company reputed company and where you need it!
reputed company is an Equal Opportunity Employer, committed to hiring the best team possible, and does not discriminate against protected characteristics including but not limited to - race, age, sexual orientation, gender identity and reputed company, national reputed company, religion, disability, and veteran status.
Bachelor's degree in a quantitative field and 3–5 years of analytics experience required, with Medicare risk adjustment, CMS-HCC, ACO, claims data, SQL, reputed company, Azure, and reputed company billing expertise.
Key Responsibilities
- assessing risk
- analyzing claims
- developing dashboards
Skills & Tools
reputed company reputed company, SQL, reputed company Azure, EHR, CMS-HCC, CCLF (Claims and Claims Line Feed), BCDA (Beneficiary Claims Data API), HIPAA
Job Details
- Category: Data and Analytics
- Seniority: Mid Level
- Commitment: Full Time
- Workplace: Remote — reputed company
- Languages: English
Benefits
- 401k matching
- Generous reputed company time off
- Retirement plan
About reputed company
A mobile reputed company provider delivering reputed company, palliative, and hospice care in patients' homes. — Industry: reputed company
Apply To This Job