200+ applicants
Horizon Blue Cross Blue Shield of New Jersey · 2 days ago
Risk Adjustment Data Analyst II
United States
Full-time
Remote
Mid Level
$68K/yr - $92K/yr
3+ years exp
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Hiring Manager
Jonathan Bivas
Insider Connection @Horizon Blue Cross Blue Shield of New Jersey
Responsibilities
Collaborate with internal and external stakeholders involved in Risk Adjustment data submission, as well as all other mandatory aspects of Risk Adjustment.
Support Risk Adjustment Data Validation (RADV) audit, including exporting and analyzing data and providing data support for operational team.
Maintain and implement technical documents and high level solution designs.
Identify process improvements by researching root causes for data deficiencies, data leakage, and encounter data rejections resolution.
Actively contribute to error resolutions of both prospective and retrospective encounter data submission reconciliation processes.
Conduct gap analysis, data collection and validation related to Risk Adjustment activities.
Participate in the development, testing and implementation of system specifications.
Develop and maintain tracking reports across multiple processes.
Participate in the peer review process.
Performs other functions as assigned by management.
Qualification
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Required
Bachelor’s degree preferred from an accredited college or university preferably in Computer Science, Data Science or other strong analytical field.
Minimum of three (3) years of experience with programming or analytics, preferably in health care, insurance or related field.
Experience using programming and statistical software (e.g., SAS), use of various databases and other data sources, and performing analytics.
Knowledge in Excel (including pivot tables) and Access required.
Knowledge of SAS, Oracle, or SQL required.
Strong analytical, research and problem-solving skills.
Proficiency in Microsoft software applications.
Proficiency in either SAS or SQL.
Ability to perform and interpret a variety of data analyses.
Preferred
Knowledge of R and Python is a plus.
Knowledge of risk adjustment programs for Medicare/Medicaid, or risk mitigation programs under ACA, is a plus.
SAS, Oracle, or SQL certification a plus.
Benefits
Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement
Company
Horizon Blue Cross Blue Shield of New Jersey
Horizon Blue Cross Blue Shield of New Jersey is a company that provides health insurance products.
5,001-10,000 employees
H1B Sponsorship
Horizon Blue Cross Blue Shield of New Jersey has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Trends of Total Sponsorships
2023 (5)
2020 (1)
Funding
Current Stage
Late StageLeadership Team
Gary St. Hilaire
President & Chief Executive Officer
Allen Karp
Executive Vice President
Recent News
Montclair Local News
2024-04-25
Fierce Healthcare
2024-04-25
Company data provided by crunchbase
