Healthcare Data Analyst

Pulse8
Full time
Healthcare
United States
Hiring from: Anywhere

Title: Healthcare Data Analyst


Location: United States


About Pulse8, Inc.



  • Pulse8 is an innovative Healthcare Analytics and Technology Company that delivers visibility and transparency for Risk Adjustment and Quality Management programs.

  • We enable health plans and at-risk providers to achieve the greatest financial impact in the Health Insurance Exchange (HIX), Medicare Advantage, and Medicaid markets.

  • By combining advanced analytic methodologies with extensive health plan experience,

  • Pulse8 has developed a suite of uniquely pragmatic solutions that are revolutionizing risk adjustment.

  • Pulse8’s flexible business intelligence tools offer real-time visibility into member and provider activities so our clients can apply the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality.


What’s cool about working for Pulse8?



  • We’re a close-knit team of Healthcare and Technology experts dedicated to helping people live longer, healthier lives.

  • You’ll get to help us design and build innovative solutions from the ground up and have the opportunity to do lots of interesting things in an entrepreneurial culture. We offer competitive benefits and much, much more!


Position Description



  • Healthcare Data Analyst will assist our organization as a subject-matter-expert in Medicare Advantage and/or Affordable Care Act (ACA) Risk Adjustment by leading business cases for algorithm development and improvement, researching customer queries of analytics performance, and creating requirements for new analytics and data products.


This is a remote position.


Responsibilities



  • Developing business cases and requirements for Risk Adjustment analytics such as condition gap opportunities, Risk Score modeling, and financial impacts and trending.

  • Leading customer requests for in-depth research and analysis.

  • Owning customer financial improvement modeling and engaging directly with current or new customers to update models.

  • Leading research initiatives to monitor Pulse8’s algorithm performance over time and recommend future enhancements.

  • Collaborating with Pulse8 clinicians in outcomes, algorithm performance, and new product development.

  • Developing customer presentations and reporting enhancements to streamline Pulse8 operations and support processes.

  • Providing training and guidance to customers and other teams on all facets of the Risk Adjustment process, from initial data capture at point-of-care, through acceptance to CMS, and successfully validated through audit.

  • Researching government regulatory guidance, providing expert interpretation for impacts to Pulse8 products and customers.


Qualifications


Academic and Professional Qualifications:



  • Bachelor’s degree in Actuarial Science, Math, Statistics, or in a related field of study


Experience:


Minimum Essential Knowledge / Skills:



  • 5 or more years of experience analyzing and interpreting MA/ACA Risk Adjustment data

  • Experience supporting the development of scalable analytic and reporting solutions

  • Extensive experience in healthcare industry, with a focus on Risk Adjustment

  • Experience with MA/ACA Risk Scoring methodology, including familiarity with condition categories (HCC)

  • Experience interacting with large amounts of healthcare data

  • Experience working with clinical classification such as diagnoses (ICD), procedures (HCPCS, CPT) and claims processing

  • Experience working with data to and from submission systems (RAPS, EDPS, Edge), including background on filtering logic for each system

  • Experience with SQL or SAS

  • Experience with MA mid-year and final year projections (MYRA, FYRA) and/or ACA transfer payments

  • Working knowledge of statistics with ability/interest to become proficient

  • Proven technical, analytical and problem solving

  • Strong written and verbal communication

  • Professional and interpersonal

  • Self-initiative and leadership

  • Ability to work within a team environment

  • Ability to interface with both external and internal personnel at all levels.


Travel Requirements:



  • Will travel to Annapolis, MD for new hire orientation

  • All Pulse 8 employees attend two company summits per year in various locations.


How to apply

To apply for this job you need to authorize on our website. If you don't have an account yet, please register.

Post a resume

Similar jobs

Title: Medical Subject Heading (MeSH) Indexer Location: USA – Virtual – Remote LAC Group is seeking an experienced, remote Medical Subject Heading (MeSH) Indexer to work on a tremendous research project associated with a distinguished University. The project will focus...
Healthcare
United States
Hiring from: Anywhere
Experienced Audio Medical Interpreter – World Languages ADVANCED MEDICAL TERMINOLOGY REQUIRED Advanced medical terminology knowledge include, but not limited to: Cardiac, Cardiovascular, Respiratory, Oncology, Gastro, Neurovascular, Neuromuscular, Immune Disease, Hypertension, Wound Care, Pediatrics, Births, Medical Conditions, Procedures, General Surgery Terms,...
Healthcare
United States
Hiring from: Anywhere
Public Consulting Group - PCG
Full time
Title: Contact Tracer Location: Arkansas or USA-Remote Overview The aim of this initiative will be to call every person diagnosed with COVID-19, establish all contacts of this person, and proceed to call and maintain ongoing communication with every contact. In...
Healthcare
United States
Hiring from: Anywhere
MicroTasks.io

Want to take classes online or need someone to deliver food?

All from the comfort of your home.

LEARN MORE