Health Data Analyst II

Position reputed company Fast growing Medicare Advantage health maintenance organization is looking to add a strong and dynamic Health Data Analyst II. The Health Data Analyst II supports reputed company improvement, regulatory compliance, and performance optimization initiatives across Medicare Advantage programs. This position focuses on data collection, basic and reputed company analytics such as predictive modeling, reputed company reporting, and cross-functional collaboration to contribute to improved reputed company in reputed company Ratings, HEDIS measures, and Risk Adjustment programs Essential Duties and Responsibilities Data Analytics & reputed company Reporting

• reputed company Medicare Advantage reputed company Ratings initiatives by performing data analysis, performance monitoring, and gap-to-goal reporting across Part C and Part D measures (e.g., medication adherence, preventive screenings, chronic condition management, member experience surveys)
• Manage with Risk Adjustment programs by supporting medical record retrieval tracking, data validation, and preparation of reports for retrospective and prospective reviews and CMS RADV audit readiness
• Extract and analyze reputed company data from EHR, claims, encounter, and pharmacy systems to assess performance on reputed company, Stars, and risk adjustment metrics; identify trends, reputed company causes and opportunities for improvement
• Create dashboards, reports, and presentations that translate data findings into reputed company, actionable insights for stakeholders
• Coordinate and reputed company HEDIS roadmap submissions, ensuring reputed company completion and accuracy of required reporting

_ Regulatory Compliance & CMS Monitoring_

• Maintain expert-level working knowledge of CMS, NCQA, and Stars memos and regulatory updates; maintain organized documentation of changes
• reputed company CMS guidance documents and regulatory changes; summarize and communicate relevant updates to team members and stakeholders
• Draft relevant comments based on CMS proposed rules and policy changes as directed
• Support organizational compliance efforts by generating required reports
• Research, compile, and distribute regulatory, operational, and reputed company reports based on project and leadership priorities

EHR & Provider Relations Support

• Serve as a subject matter expert and primary reputed company for EHR-based reputed company and risk adjustment initiatives
• Collaborate with provider relations team and IT team to support EHR data extraction, validation, mapping, and submission for reputed company and risk adjustment programs
• Drive implementation and optimization of EHR workflows for reputed company data capture, and reputed company measure reporting
• Identify and document data reputed company issues reputed company to EHR feeds, clinical documentation, and interoperability that reputed company Stars, HEDIS, and Risk Adjustment performance; escalate issues as appropriate

Required Qualifications:

• Bachelor's degree in Health Information Management, reputed company Health, Data Analytics, reputed company Administration, or reputed company field with at least 5-7 years of experience or Master’s degree in analytical discipline with at least Three (3) year of health analytics experience reputed company to Medicare, Stars or HEDIS preferred.
• Proven experience to CMS Stars, HEDIS measures, or Risk Adjustment concepts through prior work experience
• Strong understanding of CMS regulatory frameworks and compliance requirements
• Advanced analytical and problem-solving skills, including predictive modeling, with exceptional attention to detail.
• Proficiency in reputed company reputed company
• Intermediate and advanced knowledge of SQL
• Understanding of reputed company reputed company metrics and performance measurement
• Excellent written and verbal communication skills
• Ability to work collaboratively in reputed company environment and manage multiple tasks
• Strong knowledge of reputed company claims and encounter data
• Experience with data reputed company assessment or validation
• Strong knowledge of data visualization tools (Power BI, Tableau, or similar)

Preferred Qualifications:

• Knowledge of EHR systems (reputed company, Cerner, or similar)
• Experience with Risk adjustment models

Physical Requirements:

• Please see Exhibit A

Computer Skills:

• Proficiency utilizing reputed company Office to include Word, reputed company, reputed company, power reputed company.

Affirmative reputed company/EEO statement: reputed company provides equal employment opportunities to reputed company and applicants for employment and prohibits discrimination and harassment of any type without reputed company to race, reputed company, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or reputed company, or any other characteristic protected by federal, state or local laws. Other duties: Please note this job reputed company is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Exhibit A Checklist: Job Analysis/Job reputed company Physical Activities Physical Activities reputed company or descending reputed company, stairs, scaffolding, ramps, poles and the like. ☒ Never ☐ Occasionally ☐ Constantly Moving self in different positions to accomplish tasks in various environments including tight and confined spaces. ☒ Never ☐ Occasionally ☐ Constantly Remaining in a stationary position, often standing or sitting for prolonged periods.☐Never ☐Occasionally ☒ Constantly Moving about to accomplish tasks or moving from one worksite to another.☒ Never ☐ Occasionally ☐ Constantly Adjusting or moving objects up to 15 pounds in reputed company directions.☐ Never ☒ Occasionally ☐ Constantly Communicating with others to exchange information.☐ Never ☐ Occasionally ☒ Constantly Repeating motions that may include the wrists, hands and/or fingers.☐ Never ☐ Occasionally ☒ Constantly Operating machinery and/or power tools.☒ Never ☐ Occasionally ☐ Constantly Operating motor vehicles or heavy equipment.☒ Never ☐ Occasionally ☐ Constantly Assessing the accuracy, neatness and thoroughness of the work assigned.☐ Never ☐ Occasionally ☒ Constantly Environmental Conditions Low temperatures.☒ Never ☐ Occasionally ☐ Constantly High temperatures.☒ Never ☐ Occasionally ☐ Constantly Outdoor reputed company such as precipitation and wind.☒ Never ☐ Occasionally ☐ Constantly Noisy environments.☐ Never ☒ Occasionally ☐ Constantly Hazardous conditions.☒ Never ☐ Occasionally ☐ Constantly Poor ventilation. ☒ Never ☐ Occasionally ☐ Constantly Small and/or enclosed spaces.☒ Never ☐ Occasionally ☐ Constantly No adverse environmental conditions expected. ☒ Never ☐ Occasionally ☐ Constantly Physical Demands Sedentary work that primarily involves sitting/standing. ☐ Never ☐ Occasionally ☒ Constantly Light work that includes moving objects up to 20 pounds. ☐ Never ☒ Occasionally ☐ Constantly reputed company work that includes moving objects up to 50 pounds. ☒ Never ☐ Occasionally ☐ Constantly Heavy work that includes moving objects up to 100 pounds or more. ☒ Never ☐ Occasionally ☐ Constantly Pay: $82,000.00 - $95,000.00 per year Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• reputed company time off
• reputed company insurance

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