What are the responsibilities and job description for the Risk Adjustment and Data Submission Specialist position at Point32Health?
Job Description:
About the Role:
We are looking for a highly motivated and detail-oriented Data Analyst to join our Risk Adjustment Department. As a key member of our team, you will be responsible for supporting critical data submission functions, including internal data reconciliations, data transfers between Point32Health and external stakeholders, and identifying and escalating issues appropriately.
Key Responsibilities:
- Support the Director across a range of activities, including monthly encounter data submission to the Executive Offices of Health and Human Services (RI and MA), CMS and APCD submissions to state agencies.
- Monitor ongoing encounter data/APCDs response files to identify and address discrepancies in a timely manner.
- Review monthly error reports, perform trend analysis, investigate critical errors, and work with the appropriate business area on resolution.
- Enhance and automate existing reconciliation and reporting code using advanced SAS and/or SQL skills.
Requirements:
- Bachelor's degree in a related field such as health informatics, business analysis, IT, finance, or decision modeling.
- Three to five years of experience in analytical roles in the healthcare or health insurance sector.
- Expertise in SAS Enterprise Guide/SAS Base and SQL/ProcSQL (SAS certification preferred).
- Experience with database software and reporting tools such as SQL Server, Oracle, and Cognos.
