At PopHealthCare, our mission is simple - to lead the effort in reimagining how healthcare is delivered. We are bold innovators, dedicated to making a difference and we hire wicked smart people!

At PopHealthCare, our mission is simple - to lead the effort in reimagining how healthcare is delivered. We are bold innovators, dedicated to making a difference and we hire wicked smart people! We need a sharp and nimble Data Analyst - Risk Adjustment! This is a remote full-time position.

Job Summary: PopHealthCare is seeking a highly-skilled Data Analyst to support its Risk Adjustment data analysis and programming business requirements. We are looking for a talented, industrious analyst who shows initiative and creativity and can support associated business processes as necessary. This is a multi-faceted job that requires the ability to work on more than one project at a time. The ideal candidate will have experience and/or technical skills in one or more of the areas identified below.

Essential Job Functions:

• Support all risk adjustment file management and reporting activities
• Develop programs using SQL that create and analyze large data sets
• Filter and “clean” data by creating and maintaining reports to improve data submission accuracy
• Apply various analytic tools to determine financial trends, utilization, cost-shifting, and identify potential issues in healthcare data

Minimum Skill Set:

• Working knowledge of healthcare data, including medical and pharmacy claims, CPT and ICD coding, and the claims adjudication process
• Ability to develop new programs using SQL, creating and analyzing data sets
• Ability to clean and transform data into proprietary data specifications
• Ability to work independently as well as contribute to knowledge-sharing within a team environment
• Bachelor's degree from an accredited institution or equivalent
• Advanced knowledge of SQL or SAS (Base SAS or SAS Enterprise Guide)
• Experience with large data sets in a data warehouse environment
• Advanced understanding of Excel, including VLOOKUP, as well as pivot tables
• Ability to communicate effectively and work well in a team-oriented environment

Preferred Skill Set:

• All elements of the Minimum and Standard Skill Sets as well as the following:
• Master's degree from an accredited institution with a concentration in Actuarial Sciences, Applied Mathematics or Statistics
• Experience with the CMS HCC models for ACA or Medicare
• Analytical work experience within the healthcare industry
• Working knowledge of SQL Server, PowerBI, Python, or R
• Working knowledge/experience with EDI files and transactions

PopHealthCare is an equal opportunity/equal access employer fully committed to achieving a diverse workforce.

All your information will be kept confidential according to EEO guidelines.