Job Description

Location: Steward Health Care Network
Posted Date: 1/10/2022

Steward Health Care Network (SHCN) takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians, and hospitals across the continuum of care. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world-class doctor close to where they live.

The network is also responsible for the implementation and execution of our managed care contracts, medical management services, quality improvement programs, data analysis, and information services.

Position Purpose: The Senior Analyst will support the risk adjustment optimization efforts for all lines of healthcare business with emphasis on Medicare ACO, Direct Contracting and Medicare Advantage risk contracts. The Senior Analyst will demonstrate strong knowledge of performance indicators and deliver actionable data and key business insights to the Steward Health Care Network (SHCN).

  • Performs all data and analytic functions required for risk adjustment model building; financial impact analyses will evaluate new government guidelines, methodology changes and program operations.
  • Collaborates with finance and contracting teams to advance Medicare Advantage business development strategies
  • Delivers accurate and on-time deliverables, including supplemental submissions, operations and financial reports, predictive models, and ad-hoc analyses
  • Calculates ROI for risk adjustment vendor arrangements
  • Maintains current knowledge of CMS Medicare HCC and CMS HHS HCC risk adjustment models; and develops strong working knowledge of common industry models such as DxCG, ACG and Milliman MARA.
  • Provides insightful interpretations and gaps in medical claim reconciliation to both SHCN national leadership and regional operations leads.
  • Responsible for risk adjustment metrics generated for provider engagement scorecards
  • Respects the confidential and sensitive nature of patient health information, maintaining the highest degree of compliance to internal and national governing regulations
  • Other duties as assigned based on business needs

Education / Experience / Other Requirements

Education:

  • BA/BS required; Master's degree preferred

Years of Experience:

  • 2-3 years of experience with Risk Adjustment analytics
  • 3-5 years healthcare analytics experience

Specialized Knowledge:

  • Analytic and technical skills coupled with the ability to translate complicated data into useable information.
  • Strong interpersonal skills and ability to interact positively with a wide range of constituents.
  • Ability to work both independently and within a team environment and a multi-dimensional environment. Creative, flexible, self-motivated, professional must possess sound judgment consistent with achieving service excellence.
  • Ability to function effectively within an ever-changing environment and to meet deadlines and reprioritize as necessary.
  • Working knowledge of Medicare billing practices.
  • Possess strong skills in SQL, Excel, Access, PowerPoint and BI visualization tools, preferably tableau
  • Data science applications (e.g., R, Python, etc.) to build predictive model

This position is subject to the COVID-19 Vaccination Policy for Steward Health Care Workforce. Employees in this position will be required to provide adequate proof of vaccination for COVID-19 by an FDA-approved vaccine prior to starting work. Steward will consider requests for exemptions from this vaccine requirement on the basis of medical condition or sincerely held religious belief in accordance with applicable Federal laws.

Steward Health Care is an Equal Employment Opportunity (EEO) employer. Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.


Additional Information

Steward Health Care Network is taking additional, necessary preparations to ensure patients can receive compassionate care in a safe, carefully managed environment – with confidence and without fear.

Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience:

  1. Any COVID-19 related care takes place in designated areas away from other patients and their families.
  2. A stringent cleaning policy has been implemented throughout our facilities.
  3. A strictly controlled visitor and masking policy is required for patient and colleague safety.

You can rest assured that we have made the necessary preparations to provide care in a safe, controlled and professional way.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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