Medicare Risk Modeling Manager
Impact Analytics, Permanent Remote
Posted on 2/8/2023
Bethesda, MD, USA
Experience Level
Desired Skills
Data Analysis
Data Science
  • Excellent quantitative analysis abilities grounded in Medicare Advantage risk adjustment
  • Deep expertise related to HCC modeling and CMS methodologies
  • Expertise in value based care and Medicare Advantage policy, plan operations, data, and financial methodologies
  • Demonstrated ability to conduct nuanced analyses to produce accurate and unbiased results and tell the story of those results in data visualizations and reports
  • Substantial experience with healthcare data sources such as claims, electronic health record, event notification, clinical, and patient reported data
  • Advanced data manipulation skills, including a strong foundation in SQL programming
  • Knowledge of standard methods for measuring health care utilization, spending, quality, and outcomes;provider profiling; and related analytical tasks
  • Critical thinking skills and ability to find solutions while building the process
  • Intense attention to detail and data quality assurance
  • Ability to thrive in a fast-paced environment and manage competing deadlines and priorities
  • Experience leading in a highly matrixed environment, people management experience
  • Conducting in depth analyses to drive organizational learning about risk adjustment performance, with an initial focus on Medicare Advantage value based care contracts
  • Designing and executing analyses to monitor trends in ACO risk score and spot unexpected patterns in the data. Leveraging a deep understanding of program rules and related data sources including claims
  • Partnering closely with colleagues in the Performance and Finance domains to understand analytics needs and monitor, forecast, and explain ACO performance
  • Partnering closely with data engineering and ingestion teams to ensure claims and other data sources are able to support high priority analyses
  • Designing and executing analyses to identify opportunities to improve care delivery, contribute to population health product development, and inform Aledade's growth strategy
  • Working with teams across Aledade to identify implications of analysis results and translate findings into action. Developing dashboards, reports, and data visualizations that communicate insights from the data and inspire action
  • Presenting analysis results to internal and external audiences
  • Mentoring junior team members and serving as a key subject matter expert for the company
  • Translating strategic plans into tactical decisions and efforts
  • Developing project plans and building internal capabilities to project adjusted risk scores for attributed populations
Desired Qualifications
  • Expertise in descriptive analysis methods. Experience with predictive analysis, machine learning, or data science methods is a plus

501-1,000 employees

Primary care physician platform