AdventHealth · 3 hours ago

Senior Medicare Data & Finance Analyst

Altamonte Springs, FL

Full-time

Remote

Senior Level

5+ years exp

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Responsibilities

Using analytics software such as Lightbeam and/or direct queries against the data warehouse to derive insights on medical cost opportunities, risk adjustment accuracy opportunities, quality opportunities, and overall financial performance

Using SQL, PowerBI, and Excel to create custom reports and analyses for operators

Reviewing Medicare Advantage and ACO REACH data sets from payors for accuracy and validating report accuracy of systems that leverage this data

Constantly asking questions, performing data mining, and finding insights in the risk-based Medicare Advantage and ACO REACH data

Perform analysis of risk-based Medicare populations and program data to identify key areas of improvement opportunity

Analyze data in cohorts by clinic, provider, length of time the member has been with the practice and much more to identity what cohorts are driving profitability and what cohorts require actions to improve performance

Create core reporting dashboards summarizing and trending all aspects of Medicare business, CMS Revenue, Enrollment, Risk Adjustment, cost trend, and quality

Serve as the liaison between the PHSO and the risk-based practice team for all Medicare and Medicare Advantage reporting needs

Solicit and incorporates input from peers, customers, and management for process improvements

Apply knowledge of new trends in healthcare which may involve data management and analytics

Builds strong relationships with leadership, customers, and peers. Communicates appropriately and effectively with stakeholders, customers and supervisors, maintaining awareness of any issues, potential delays, and any situation of concern that may affect the productivity of supported programs, processes and systems

Effectively uses past experiences and job knowledge to identify and resolve any data or program implementation problems within area of responsibility. Involved in problem-solving issues related to program delivery, program engagement and health-related outcomes

Present analyses and findings to finance team, operations team, providers, and senior leadership.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

SQLPowerBIHealthcare AnalyticsSASSPSSRTableauBusiness ObjectsRisk AdjustmentLightbeamActuarial ScienceMathematicsComputer ScienceFinanceEconomicsStatistics