Data Integration Analyst, AI – Risk Adjustment

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the technical liaison for receiving customer health-plan data in various formats, including member, provider, clinic location, chart-retrieval details, and claims data.

• Ingest source data in its original form into the SQL Server data warehouse while maintaining raw data for traceability.

• Create scalable, repeatable ingestion routines for diverse data structures and file types.

• Develop and maintain SQL scripts to transform raw source data into accurate, platform-ready outputs, including medical record retrieval load files.

• Monitor data pipelines for errors, anomalies, and quality issues, addressing them prior to downstream impacts.

• Establish and maintain data foundations that support retrospective risk adjustment coding workflows.

• Create, test, and enhance condition-suspecting algorithms for likely undocumented or under-documented diagnoses.

• Collaborate with coding, clinical, and analytics teams to translate domain logic into production-quality data products.

• Design and construct semantic data structures that enhance healthcare data accessibility for AI tools.

• Refactor and clean a library of semantic analytics tables, migrate it into production, and implement automated scheduled refreshes.

• Set standards for promoting code from development to production and creating structured, reusable datasets.

• Document data models, transformation logic, algorithms, and source-specific rules.

• Collaborate with Data Management, analytics, and platform teams on production systems and transitions.

• Partner with the VP of Data Strategy and cross-functional teams to enhance the processes from raw data to AI-ready assets.

• Report directly to the VP of Data Strategy.

⛳️ Requirements

• Bachelor's degree in a quantitative, scientific, technical, or related field, or equivalent hands-on experience.

• Proven hands-on coding skills and demonstrable experience with database technology.

• Experience with SQL Server / T-SQL or a similar relational database.

• Ability to design innovative, original solutions to parse, structure, and interpret complex, messy, or unfamiliar data.

• Comfort in designing, testing, and refining algorithms or analytical logic using real-world data.

• Experience in cleaning, mapping, and validating real-world data from multiple sources and file formats into a required structure.

• Experience in building repeatable, maintainable ETL or data-ingestion workflows.

• Strong attention to detail and a systematic, methodical approach to data quality and validation.

• Excellent written and verbal communication skills, including the capability to work directly with customers and internal teams.

• A self-starter who takes ownership from start to finish and thrives in an autonomous environment.

• Preferred but not required: Healthcare or health insurance experience.

• Preferred: Graduate study or research experience in a quantitative or scientific discipline.

• Preferred: Familiarity with SSIS or comparable ETL tools.

• Preferred: Exposure to Python for data manipulation and automation.

• Preferred: Understanding of risk adjustment, HCCs, condition suspecting, medical record retrieval, or value-based care operations.

• Preferred: Experience preparing, structuring, or engineering data for AI/ML tools and workflows.

• Preferred: Experience supporting customer onboarding or client data implementations.

• Reveleer E-Verifies all new hires.

🏝️ Benefits

• Competitive salary.

• Medical, Dental, and Vision benefits.

• 401k match.

• Generous PTO plan.