About of Advantmed{{:}}
Advantmed is a leading provider of risk adjustment, quality improvement, and value-based solutions to health plans and providers. We drive market-leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance and the proactive clinical engagement of high acuity populations.
Job Summary{{:}}
As Director of Analytics, you will lead projects and initiatives that support the growth and advancement of Advantmed's analytics capabilities and advancement of the Elevate Risk Adjustment Insights (ERAI) Platform. Responsibilities include improving and executing chase list logic, gathering analytics requirements, creating custom reports, researching internal product and operational issues, and performing ad hoc queries and problem solving. The role also includes the ability to speak to clients about their analytic needs, respond to client inquiries and requests, answer their questions, and explain the value and importance of analytics created for them.
The Director of Analytics will be technically skilled in developing complex queries and automated processes that process large amounts of data and generate insights that are valuable to our clients. This position will be able to work independently with most of the time spent doing hands-on analytics that are needed to support our clients, our products, and to explore new opportunities. This individual will be a Subject Matter Expert (SME) on Risk Analytics and have detailed knowledge of the HCC risk model for Medicare and Commercial ACA lines of business. Also needed is a thorough understanding of risk adjustment services that Advantmed offers, including Record Retrieval (RR), Medical Record Review (MRR), and Prospective Health Assessments (PHA). Depending on the company's revenue growth, this position may also have direct reports and lead a team to achieve more goals in the future.
Responsibilities{{:}}
- 1. Manage the day-to-day analytics needs by acting as the primary data analyst resource for the Client Success team
- Serve as a Subject Matter Expert (SME) on risk adjustment and risk analytics for the Medicare and Commercial ACA lines of business
- Lead discussion in client meetings and Quarterly Business Reviews, serving as an SME in risk adjustment and risk analytics to achieve client goals
- Maintain, improve, and execute existing analytics logic and processes that meet the needs of our clients, products, and services.
- Develop new, insightful, and innovative analytics that add value to our clients, products, and services
- Be able to calculate the project ROI for Record Retrieval (RR), Medical Record Review (MRR), and Prospective Health Assessment (PHA) projects
- Research client data, product operations, and performance issues that reduce client satisfaction and negatively impact our value story
- Collaborate with divisional team leaders on product/service issues, including leading discovery, analytics, problem solving, and issue resolution
- Prepare analytics, metrics, ROI, and risk adjustment strategy for client Quarterly Business Reviews (QBRs) and Annual Business Reviews (ABRs)
- Support ERAI product enhancements and product roadmap with industry knowledge and expertise to continually improve our competitive offering.
- Perform QA of analytics and ERAI risk scoring engine runs, including modifications needed due to annual HCC risk model changes.
- Have the capability of leading a team of data analysts in the future as the business grows
Requirements
- Bachelor's Degree in math, computer science, or related field is desired.
- 7+ years of experience in risk adjustment, risk analytics, and maintaining risk models for Medicare and Commercial ACA lines of business
- 5+ years of experience supporting prospective and retrospective risk adjustment projects including calculation of ROI
- 5+ years of hands-on experience writing SQL, responding to client requests and developing custom reports.
- Subject Matter Expertise (SME) in Medicare and Commercial ACA risk adjustment
- Experience in AI used to improve suspecting logic is highly desired
- Strong track record of success in supporting risk analytics, client requests, production support, and problem resolution
- Outstanding communication and presentation skills needed to lead both internal and external meetings and to provide client support
- Ability to manage a team of data analysts and subject matter experts to support Advantmed's growing analytics capabilities and advancement of the ERAI Platform
