Medicare Advantage Risk Adjustment Business Data Analyst (Los Angeles)

Description

As the Business Data Analyst for our Medicare Advantage Risk

Adjustment team, you will be responsible for producing accurate and insightful

department measurements used in both internal and external reporting.

You will :

Ensure data quality and accuracy through

rigorous assurance checks.

Develop and maintain reports, from ad hoc

requests to scheduled production reports.

Write clear specifications and design data

queries for healthcare performance measures.

Apply technical expertise to gather requirements

and translate them into effective reports and data integration projects.

Manage complex data projects that require

periodic updates on weekly, monthly, quarterly, or annual cycles.

Collaborate closely with Decision Support

Services and Health Outcome & Analysis teams to transition ongoing reports

into production environments.

Interpret and document detailed written and

verbal specifications, ensuring a comprehensive understanding of data

relationships across encounters, claims, membership, and provider databases.

Develop or apply technical specifications for

healthcare measures from organizations such as CMS, DHCS, NCQA, and others.

Serve as a key departmental resource for

application use related to risk adjustment coding guidelines and gap closure

reporting.

Salary Range : $78,500 - $163,600 / annually Qualifications We are seeking an analytical, self-directed, detail-oriented individual

with : A Bachelor's

degree in an IT related field or equivalent experience

A Master's

degree in related field, preferred

3-5+ years

in healthcare IT experience, highly desired

3-5+ years

of experience with Epic Clarity reporting

3-5 years of

experience building and maintaining Tableau dashboards

Proven

experience generating reports using healthcare data, with a focus on

encounter / claims, membership, and provider datasets, required

Solid

understanding of common healthcare measurement frameworks and definitions,

including Risk Adjustment HCC models from CMS, required

Strong

analytical and problem-solving capabilities

Ability to

work independently with minimal supervision while managing priorities

effectively.

Excellent

communication skills to engage with stakeholders across all levels and gather

clear requirements.

Demonstrated

ability to set, track, and meet goals within established timelines.

Proficient

in SQL programming, particularly on MS SQL Server and Oracle platforms,

required

Familiarity

with statistical methods and their application in data analysis, required

Knowledge of

data warehouse architecture, data structures, and best practices in reporting.

Extensive

understanding of healthcare industry standards, workflows, policies,

procedures, and system environments.

Strong

metadata management skills with the ability to analyze complex datasets.

Skilled in

translating business questions and requirements into actionable reports,

database views, and BI query objects.