Senior Data Analyst, Risk Adjustment

📋 Description

• Take charge of monitoring and managing the complete data flow of submissions to vendors and government entities to prevent data leakage and submission inaccuracies.

• Assume ownership of the claim and supplemental submission processes for the Centers for Medicare & Medicaid Services (CMS) Encounter Data System (EDS) submissions.

• Create data pipeline tracking reports and analyze, investigate, and rectify encounter data discrepancies.

• Provide support for the claim and supplemental submission workflows related to CMS EDS submissions.

• Collaborate effectively with both the Engineering and Risk Adjustment teams.

• Assist in tracking and implementing initiatives and strategies related to risk adjustment.

• Maintain, revise, and develop policies, procedures, and other documentation concerning the encounter process.

⛳️ Requirements

• You possess two years of experience with Medicare Risk Adjustment, CMS Encounter Data System (EDS) submissions, and healthcare claims data.

• You have a minimum of two years of programming experience with SQL, Python, and R.

• You are experienced in creating operational-level dashboards.

• You are a self-motivated individual with a strong internal drive and a commitment to high-level execution.

• You maintain a relentless focus on meeting the needs of diverse business clients.

🏝️ Benefits

• Financial Well-Being: Our dedication to attracting and retaining top-tier talent starts with a competitive base salary and equity opportunities. We also provide a performance-based bonus program, 401k matching, and regular compensation reviews to acknowledge and reward outstanding contributions.

• Physical Well-Being: We prioritize the health and well-being of our employees and their families by offering comprehensive medical, dental, and vision coverage. Your health is a priority for us, and we invest in ensuring you have access to quality healthcare.

• Mental Well-Being: Recognizing the significance of mental health in enhancing productivity and maintaining work-life balance, we provide initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. We also embrace a remote-first culture that fosters collaboration and flexibility, allowing our team members to excel from any location.

• Professional Development: Cultivating internal talent is a key focus for Clover. We offer learning programs, mentorship, funding for professional development, and regular performance feedback and evaluations.

• Additional Perks: Employee Stock Purchase Plan (ESPP) providing discounted equity opportunities.

• Reimbursement for expenses related to office setup.

• Monthly stipend for cell phone and internet.

• Remote-first culture that facilitates collaboration with global teams.

• Paid parental leave for all new parents.

• And much more!