Senior Medicare Data & Finance Analyst Job at AdventHealth in Altamonte Spri

Senior Medicare Data & Finance Analyst Location: Virtual All the benefits and perks you need for you and your family: Benefits from Day One Career Development Whole Person Wellbeing Resources Award-winning IT Department Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. Schedule: Full-Time, Monday – Friday The role you’ll contribute: The Senior Medicare Data & Finance Analyst is responsible for serving analytics needs across operations and finance in support of risk-based Medicare ventures. This role will include leveraging data from electronic health records, claims, and payer reports by means of SQL queries, business intelligence solutions, and analytics software (such as Lightbeam) to derive insights and create reports that help lower medical cost trend, improve accurate documentation, and improve STARs scores. The Senior Medicare Data & Finance Analyst will engage with the finance team, operations team, health plan partners, providers, and vendors in the pursuit of identifying and sharing insights that improve operational, clinical, and financial performance. The Analyst will use healthcare data (claims, labs, MMR data, EHR data, ENS data, etc.) to identify trends and opportunities in medical cost, risk score, quality, and overall financial performance. The role will require never-ending curiosity, the ability to work well with diverse teams, excellent analytical skills, a deep understanding of the Medicare Advantage program and data, and a high degree of creativity and accountability. The value you’ll bring to the team: 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. Qualifications The expertise and experiences you’ll need to succeed: Minimum 5 years’ experience in analytics with a Medicare Advantage Plan or senior value-based care provider Bachelor’s degree in Actuarial Science, Mathematics, Computer Science, Finance, Economics, Statistics or analytical related field Technical experience in utilizing SQL, PowerBI, and other software tools and applications Experience with statistical applications like SAS, SPSS or R Experience with analytics interfaces such as Tableau, Business Objects Experience in analytics with emphasis in healthcare and/or clinical application and health insurance finances Experience in risk adjustment EDUCATION AND EXPERIENCE PREFERRED: Experience with analytics software (such as Lightbeam) Experience working on the Medicare Advantage Bid process Master’s degree in analytical or Healthcare field This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location. Category: Accounting/Finance Organization: AdventHealth PHSO Resources Schedule: Full-time Shift: 1 - Day Req ID: 24041904 We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.