Healthcare Data Analyst Consultant; Risk Adjustment & Stars

Job Title

Job Overview:
Pay Range: $72.23hr - $77.23hr

The role involves supporting enterprise Risk Adjustment and Stars strategies through advanced analytics, reporting, and collaboration with healthcare policy makers, business leaders, IT teams, and product owners. The role involves identifying trends and opportunities across Medicare and Medicaid programs, developing analytical models and visualizations, supporting quality and risk initiatives, and delivering data-driven recommendations that improve business outcomes.

• Strong experience in healthcare data analysis, modeling, and reporting.
• Expertise in Medicare Advantage, Medicaid, Risk Adjustment, and Stars programs.
• Strong programming experience with SQL, Python, R, SAS, or similar technologies.
• Experience developing reports, dashboards, and visualizations using Power BI or Tableau.
• Strong analytical and problem-solving skills.
• Experience transforming, cleansing, and validating large data sets.
• Strong understanding of relational databases, dimensional modeling, and star schemas.
• Ability to manage multiple priorities and deliver results in fast-paced environments.
• Strong communication and collaboration skills across business and technical teams.

• Bachelor’s degree in Data Science, Mathematics, Computer Science, Statistics, or related field required.
• 10 years of experience in data science methodologies, analytics, modeling, and reporting required.
• Master’s or PhD in related disciplines preferred.
• Experience with Azure Cloud native programs preferred.
• Agile software development experience preferred.
• Experience working with large datasets and distributed computing technologies such as Hive or Hadoop preferred.
• Experience working with healthcare data including EMR, clinical data, or social determinants of health preferred.

• Support enterprise Stars and Risk Adjustment strategies through advanced analytics and collaboration with stakeholders.
• Identify trends and opportunities across Medicare and Medicaid healthcare programs.
• Partner with business leaders, IT teams, and product owners to guide analytics initiatives and priorities.
• Identify and quantify key drivers impacting Risk Adjustment and Quality/Stars programs.
• Investigate opportunities, evaluate effectiveness, and provide actionable recommendations.
• Develop and maintain reports, dashboards, and visualizations for business stakeholders.
• Create scheduled and ad hoc reports to support Risk Adjustment and Quality initiatives.
• Monitor application performance and recommend process and algorithm improvements.
• Work with clients, data stewards, and technology teams to define business problems and solutions.
• Stay current with Medicare and Medicaid regulatory requirements and update analytics accordingly.
• Collaborate with external vendors and government agencies as needed.
• Manage multiple concurrent projects and shifting priorities effectively.

• Experience with Azure Cloud environments.
• Experience with Hive, Hadoop, or distributed computing frameworks.
• Experience working with unstructured healthcare data.
• Agile software development experience.
• Experience with healthcare quality and risk adjustment programs.

• Risk Adjustment and Stars analytics.
• Medicare and Medicaid healthcare analytics.
• SQL, Python, R, and SAS programming.
• Power BI and Tableau visualization.
• Data modeling and dimensional design.
• Data cleansing and transformation.
• Relational databases and star schemas.
• Healthcare data analysis.
• Analytical problem-solving.
• Reporting and dashboard development.

• Bachelor’s degree in Data Science, Mathematics, Computer Science, Statistics, or related field required.
• Master’s or PhD preferred.
• Additional relevant work experience may be considered in lieu of degree requirements.