Risk Adjustment Analyst - SQL/SAS position located in Virginia Beach Job

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Risk Adjustment Analyst - SQL/SAS (position located in Virginia Beach)
Job ID 2013-21726 # Positions 1
Location US-NATIONWIDE
Search Category Health Care Operations
Type Regular Full-Time (30 hours) Posted Date 1/16/2013
Additional Locations ..
More information about this job:
Summary:
The HCE Analyst III is responsible for collecting, analyzing and interpreting health care data, including claims, clinical, member, and provider information applying problem solving skills to deal creatively with complex less clearly defined situations. Works directly with Plan and Corporate Office customers and business owners to provide solutions to problems of diverse scope with the goal of identifying areas of opportunity for formulation and implementation of strategic initiatives. This position will work on Premium Risk Adjustment, including conducting complex analyses, optimizing methodology, and developing algorithms related to predictive models which impact risk adjustment.
Responsibilities:
1. Responsible for conducting advanced data management.
2. Develops and executes complex programs to produce reporting deliverables.
3. Performs business requirements gathering and analysis.
4. Provides technical and/or analytical support as well as professional development to Plan Performance measurement staff.
5. Collaborates with internal and external partners and organizations to understand data needs and design analytic studies to answer business and research questions.
6. Independently structures advanced level project plans for analytical projects.
7. Interprets results and prepares findings for presentation to internal and external audiences.
8. Conducts quality reviews on own and peers- work products.
9. Integrates feedback to drive continuous improvement and grow subject matter knowledge.
10. Applies advanced financial, clinical and/or operational analysis.
11. Monitors and identifies unit cost and/or utilization risks to AMERIGROUP-s medical cost budget. Elevates and presents to HCE management as necessary.
12. Adheres to all applicable compliance standards.
13. Other job duties as assigned or requested.
Qualifications:
EDUCATION AND EXPERIENCE
Education
Required:
- Bachelor-s degree in Finance, Economics, Business Administration or a related discipline or equivalent experience.
Years and Type of Experience Required:
Required:
- Minimum of five years of related work experience in data analysis, report development, application development/implementation and /or project management.
Preferred:
- Minimum of two years experience with Managed Care Organization.
- Minimum of two years experience with government health care programs.
- Experience with Risk Adjustment methodologies or other clinical risk predictive models.
Language Skills
Required:
- English
Technical Competencies
Computer Skills and Office Equipment
- Proficiency with Microsoft Office products, Excel in particular.
- Programming language such as SQL or SAS preferred Communication skills: Verbal, Written and Telephonic.
- Strong capability to provide professional and appropriate written and verbal information to internal and external customers.
- Strong customer service/relationship skills and ability to work effectively and multi-task in a fast paced environment with shifting priorities.
Behavioral Competencies
Strategic Leadership
Be Strategic
- Demonstrates understanding of the organization's mission and strategies.
- Works to clarify and understand the broader purpose and mission of own work.
- Integrates and balances big-picture concerns with day-to-day activities.
- Generates innovative ideas and solutions to problems.
- Identifies opportunities to increase efficiency, simplicity, and revenue.
Make Sound Decisions
- Approaches problems with curiosity and open-mindedness.
- Collects sufficient information to understand problems and issues.
- Analyzes problems and issues from different points of view.
- Applies accurate logic and common sense in making decisions.
People Leadership Develop/Support Organizational Talent
- Relates to people in an open, friendly, and accepting manner.
- Treats others with respect.
- Listens carefully and attentively to others- opinions and ideas.
- Maintains positive relationships even under difficult or heated circumstances.
- Works cooperatively with people from different cultural backgrounds.
Ensure Collaboration
- Encourages people to draw on each other's strengths and experience to work together effectively, within and across teams.
- Appropriately involves others in decisions and plans that affect them.
- Provides honest, helpful feedback to others on their performance.
- Shares own experience and expertise with others.
Results Leadership Show Drive and Initiative
- Demonstrates a can-do spirit, a sense of optimism, ownership, and commitment.
- Maintains a consistent, high level of productivity.
- Takes personal responsibility to make decisions and take action.
- Does not easily give up in the face of unexpected obstacles.
- Projects a positive image and serves as a role model for others.
Accountability / Optimize Execution
- Juggles many priorities and competing demands for one's time.
- Acts resourcefully to ensure that work is completed within specified time and quality parameters.
- Removes obstacles in order to move the work forward and/or get efforts back on track. Surfaces problems and issues before projects get derailed.
PHYSICAL REQUIREMENTS
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedure.
D: JR
Amerigroup
Web: ****

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