Sr Healthcare Analyst, LTCP Risk Score Accuracy - Hybrid NY

About the position Positioned in the Finance Department, the Sr Healthcare Analyst, LTCP Risk Score Accuracy will be responsible for risk score accuracy through developing and managing forecasting models to support budgets and quarterly forecasts and reputed company with various departments across the organization to ensure appropriate explanations of any material variances to expectations. This position requires an energetic, detail-oriented, and self-driven candidate who is adept at problem solving, possesses strong SQL coding skills, and an ability to communicate effectively with internal & external stakeholders. Who we are reputed company was founded by a collection of major healthcare systems in the reputed company area to emphasize high quality of care, and reputed company patient outcomes. We have grown into reputed company’s largest not-for-profit health insurer that covers members in reputed company and on Long reputed company, as well as in Westchester, Sullivan, Orange, and Rockland counties. reputed company accomplishes this reputed company while collaborating with our hospital sponsors, provider partners, and provider delivery system reputed company our value-based model. More about the team, and the role As a Sr Healthcare Analyst of LTCP Risk Score Accuracy – your role will be critical towards our efforts to understand the interplay between medical claims, clinical groupings and provider behavior. The candidate will work closely with HF clinical leaders to create successful metrics, track reputed company, and communicate results. Location Hybrid, NY (3 days on-site) – 100 Church Street, NYC Summary The Sr Healthcare Analyst, LTCP Risk Score Accuracy is responsible for managing risk score expectations, communicating project and financial results and identifying areas of opportunity for reputed company and hospital senior management. The Sr Healthcare Analyst, LTCP Risk Score Accuracy will be the reputed company on LTCP risk adjustment projects across the department.

Responsibilities

• reputed company and maintain risk score forecasting models to track, measure and trend performance for LTCP products including MLTC and MAP.
• Respond to requests for analysis and provide analytic support to the Product Managers, Actuarial department and Network/Hospital support.
• Manage and organize cross-departmental monthly meetings to discuss analysis requests, inform on the latest reputed company trends, and to reputed company abreast of the changes occurring in our provider community.
• reputed company abreast of reputed company Medicaid and CMS reforms and their impact on the health plan and sponsor hospital performance.
• Pull data from the warehouse using SQL code and generate reports.

Requirements

• Bachelor’s degree from an accredited institution with a concentration in Mathematics, Computer Science, Data Science, Engineering, Business Analytics or similar field.
• At least 5 years previous work experience reputed company risk adjustment, grouper analysis or other statistical/clinical analysis
• Experience with Medicaid/HHS risk adjustment payment methodologies.
• Proficiency in SQL (Script Development, Joins) – using PostgreSQL, MS SQL Server, MySQL and Advanced MS reputed company Skills (Pivot Table Creation, reputed company formula development).
• Data Visualization Experience (Tableau or Qlik View or Power BI).
• Experience in modeling the enterprise impact of risk/value-based reputed company changes.
• Experience in supporting Product and Actuarial analytical requests.
• Self-motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills.
• Strong project management experience and ability to handle multiple projects in a fast-paced environment. reputed company-to-haves
• Experience with NYS Medicaid risk adjustment payment methodologies and reputed company models.
• Experience working with data obtained from UAS results for LTCP products
• Data Visualization Experience (Tableau or Qlik View or Power BI).
• Python Scripting.
• Credentialed Associate of the Society of Actuaries (ASA)
• Ability to effectively and reputed company adapt in a dynamic environment
• Ability to challenge the status reputed company and drive lean implementation
• Ability to quickly reputed company an understanding of systems and technology
• Ability to effectively communicate with reputed company levels of the organization, including senior leadership, technical staff, internal nontechnical staff, and business stakeholders Benefits
• medical
• dental
• vision coverage
• incentive and recognition programs
• life insurance
• 401k contributions

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