Comtec Information Systems · 7 hours ago
Risk Adjustment and STARS Analyst
LA
Contract
Remote
Mid Level
$30.81/hr - $35/hr
4+ years exp
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Responsibilities
Performs scientific and technical planning, analysis, reporting and methodological support to measure and improve medical diagnosis coding and documentation.
Supports leadership in reporting to assist in the planning, implementation, and measurement of coding accuracy/RADV/Stars processes.
Performs analytics and provides insights on Medicare Advantage STARs and coding accuracy.
Provides ongoing data analysis and recommends focus and direction of resources for decision makers and management that is relevant to the healthcare market; assists in problem solving, solution development, decision making, and strategic planning.
Hypothesizes and develops attributes that characterize or predict coding accuracy and Star Performance.
Leverages reporting software and models to develop attributes on population(s) and identifies opportunities to close gaps.
Performs peer data quality reviews, validating data and process to ensure accuracy, completeness, and consistency of department output; recommends process improvements as necessary. Investigates existing national and regional data and performs descriptive and analytic studies using basic analytical/statistical techniques.
Serves as technical expert advisor to collaborating departments on corporate and cross-functional projects, reports, and activities.
Collaborate with leadership to manage Risk Adjustment initiatives to improve coding accuracy & efficiency.
Analyze & prioritize suspected conditions to guide allocation of resources for Retrospective Review projects.
Facilitate necessary data elements required for chart chase projects.
Identify trends & high fail conditions in the RADV audit submission to improve diagnosis coding accuracy.
Quantify the impact of interventions to evaluate efficacy of existing programs.
Provide necessary analytic & data requirements to facilitate pilot programs, collaboration with vendors, and departmental projects.
Qualification
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Required
Bachelor's in healthcare administration, statistics, economics, analytics, computer science required
4 years of health care, analytics, IT or management consulting experience
Strong critical thinking, analytical and problem-solving skills are required
Requires experience building predictive models
Basic knowledge of United States healthcare delivery system in payer setting or provider setting is required
Must have strong knowledge of common query/analytic/visualization tools such as SQL, SAS, R, Python, Tableau, etc.
Excellent verbal and written communication skills; strong interpersonal skills. Ability to analyze, consolidate and communicate complex technical topics to all levels of internal staff and external vendors
Preferred
Master's in related field preferred
Strong knowledge of outcome research design, controlled study design is preferred
Advanced knowledge of SAS including Enterprise Miner is preferred
Strong understanding of provider payment methodologies, population health management, and risk adjustments is desired
Knowledge of commercial risk optimization and MA risk optimization is a plus
5 years of health care, analytics, IT or management consulting experience (Preferred)
5 years of Risk analysis (Preferred)
5 years of Health insurance (Preferred)
Company
Comtec Information Systems
Comtec designed and made portable wireless thermal printers.
201-500 employees
Funding
Current Stage
Growth StageTotal Funding
unknown2000-04-03Acquired· by Zebra Technologies
Company data provided by crunchbase
