HealthCare Partners, IPA and HealthCare Partners, MSO make up a healthcare delivery system serving members, providers, and health plan partners across New York. The organization is seeking a Risk Adjustment Integrity Analyst I to support analytics and operational initiatives that improve documentation accuracy, data integrity, and risk score performance.
This role bridges data analysis and operational execution by identifying documentation gaps, supporting audits, partnering with coding teams and vendors, and helping ensure accurate submissions across Medicare, Medicaid, Exchange, and Commercial lines of business. The position is well suited for an early-career healthcare analytics professional with an interest in risk adjustment, healthcare data, and compliance.
Proficiency in SQL to query, validate, and analyze healthcare data.
Strong analytical and problem-solving skills.
Familiarity with Medicare Advantage risk adjustment, Medicaid risk adjustment, or ACA preferred.
Knowledge of CMS and NYSDOH reports, including MMR, MOR, RAPS Returns, EDPS reports, plan payment reports, and 3M Medicaid reporting.
Excellent organizational skills with the ability to manage multiple projects and timelines.
Strong written and verbal communication skills.
Proficiency in Microsoft Office; experience with Python, Tableau, SAS, or similar data tools is a plus.
Strong attention to detail and commitment to data integrity and compliance.
Ability to collaborate across departments and with external stakeholders.
Bachelor’s degree preferred in public health, healthcare administration, business, data analytics, or a related field. High school diploma or equivalent required.
1–3 years of experience in a healthcare setting preferred, especially in risk adjustment, medical coding, health plan operations, or data analytics.
Familiarity with CMS audit processes and RADV procedures preferred.
Base salary of $65,000 to $75,000 annually.
Bonus incentive up to 12.5% annually based on organizational performance.
Fully paid medical and dental employee coverage.
Robust benefits package including PTO, 401(k), FSA, and tuition reimbursement.
Location
New York, US
Employment Type
Full-time
Experience Level
Entry Level
Salary Range
$65,000 - $75,000
Remote work allowed
No
Posted
1 month ago