Analytics Consultant - Risk Adjustment

| Remote
Making Healthcare Right. Together.” is the cornerstone of all we do. Our vision is through powerful relationships with Care Partners, we help all people live healthy and brighter lives. To successfully achieve our mission and vision as we operate in a dynamic health care environment, we expect Bright employees to embody and uphold our core values in work and interactions, both internal and external: be brave, be brilliant, be accountable, be inclusive, and be collaborative.

Bright Health’s Analytics Team is working to push boundaries to redefine what strong analytics can accomplish in health care. The Analytics Consultant will advance the role of analytics as a strategic thought partner across the business and will contribute to a culture of theory testing and data-driven decision making. The Analytics Consultant will be comfortable speaking both ‘business’ and ‘data’ with our internal teams and external vendors to understand business questions, develop ways to answer those questions, and communicate answers to stakeholders.

Role Responsibilities

  • Complete data analyses focused on risk adjustment for Individual & Family Plans, Medicare Advantage, and other product lines. Performs data and analytical services in support of ensuring appropriate risk-adjusted revenue, maintaining compliance with CMS standards and modeling financial impacts of changes in risk adjustment data and methodologies.
  • Support the development and implementation of best-in-class tools and capabilities to support efforts such as identification of diagnostic suspects, data reconciliations to limit data leakage, and drive bi-directional gap closure efforts.
  • Integrate with internal business partners, share market/provider-specific insights and drivers to support engagement with care delivery partners on risk adjustment initiatives.
  • Collaborate with business stakeholders to understand analytics needs, develop plans to address those needs, and analyze and interpret data to provide insights.
  • Bring together multiple sources of complex data to design and develop reports that answer a business question.
  • Understands and incorporates quality principles to ensure optimal performance of Risk Adjustment Submissions processes.
  • Maintains current knowledge of CMS' Hierarchical Condition Categories (HCC) and Prescription Drug Risk Adjustment codes (RxHCCs) including risk adjustment values and formulas.
  • Create reporting resources and datasets that are well designed, easily maintained, and repeatable.
  • Produce clear and concise summaries of analytical findings for consumption by a variety of audiences through a range of media: presentations, email summaries, executive summaries, and oral discussions.

Education, Training, Experience

  • Bachelor’s degree in analytics-related field or ten (10) or more years of professional experience required
  • Two (2) or more years of analytics experience required
  • Two (2) or more years of health care industry experience required
  • Experience working with medical or pharmacy claims required
  • Expertise with risk adjustment analytics strongly preferred
  • Experience with Encounter Data Processing System (EDPS) and/or External Data Gathering Environment(EDGE) data strongly preferred
  • Advanced level of expertise with at least one of the following analytic tools: SQL, SAS, Excel/VBA, Tableau and/or PowerBI
  • Expertise in analytics, statistics, data visualization, or programming
  • Dedicates exacting attention to detail and data quality
  • Eager learner, collaborative partner, easy communicator, and careful analyst
  • Passion for empirical research and answering hard questions with data
  • Willingness to mentor other team members and advance their knowledge

 We’re Making Healthcare Right. Together. 

We've won some fun awards like Modern Healthcare and Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our team!

Check out this great video showcasing just some of the fantastic Technology Team broadcasting from our ATX office!
 
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

BRIGHT ON!

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Technology we use

  • Engineering
  • Product
  • Sales & Marketing
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    • Aha!Management
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    • Microsoft DynamicsCRM

Location

We are downtown at 515 Congress Avenue, right in the heart of downtown! Tons of restaurants and close to public transportation.
Making Healthcare Better For All At Bright Health
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An Insider's view of Bright Health

What’s the vibe like in the office?

The office has a relaxed and laid back vibe but people are very serious about their work - perfect!

Anthony

Data Engineer

What does your typical day look like?

My day is so varied, given how quickly we're growing, which is fulfilling for me. I have a good balance of strategic and tactical work in my day as well as time to focus and time to collaborate.

Jen

VP, Digital

What makes someone successful on your team?

A hard-working team player who thinks first and codes next is likely to learn a lot and quickly become a valuable member of the team. Lots of experience with some of our tooling is always nice, but if someone can't knowledge-share well or responds poorly to code reviews and other requests for collaboration, it'll be a tough fit.

Brian

Software Engineer 3

How do your team's ideas influence the company's direction?

We hire smart individuals who thrive on accomplishment and purpose. Our teams are exposed to the bigger picture through constant communication and dialogues – that encourages them to come up with innovative solutions to problems. We've made significant adjustments on our direction in technology and process that were initiated by the team.

Abdullah

VP, Engineering

What are Bright Health Perks + Benefits

Bright Health Benefits Overview

We have 3 different health insurance plans, all through Cigna (HDP, Premium HDP and PPO). We cover the majority of the cost for the employee and some cost for family. We have two dental plans and a vision plan as well. We have a Lifestyle Spending Account and options for HSA/FSA. We put 3% of your total earnings into your 401K plan and you are immediately vested. We have all the latest technology (Mac or Surface laptops – your choice) to use including standing desks. Fully stocked fridge with snacks and drinks.

Culture
Friends outside of work
Eat lunch together
Daily sync
Open door policy
Team owned deliverables
Team based strategic planning
Group brainstorming sessions
Pair programming
Open office floor plan
Diversity
Dedicated Diversity/Inclusion Staff
Unconscious bias training
Someone's primary function is managing the company’s diversity and inclusion initiatives
Mean gender pay gap below 10%
Hiring Practices that Promote Diversity
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Bright Health employees can contribute up to $3500 annually to their FSA.
Disability Insurance
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Wellness Programs
Bright Health is proud to offer a wellness stipend of $200/month to all employees!
Onsite Gym
Mental Health Benefits
Retirement & Stock Options Benefits
401(K)
We will put 3% of your total earnings into your 401K plan, even if you don't put anything in. It's a safe harbor contribution.
401(K) Matching
Bright Health provides employees with a 401(k) plan managed by Vanguard. We provide a ‘safe harbor’ non-elective contribution equal to 3% of your compensation, regardless of participation in the p
Performance Bonus
Child Care & Parental Leave Benefits
Generous Parental Leave
We provide up to 6 weeks of parental leave for the primary caretaker. We also provide 2 weeks of leave for the secondary caretaker.
Flexible Work Schedule
Bright Health provides employees with a flexible work schedule that includes Core hours, Flexible start and end times.
Remote Work Program
Family Medical Leave
Company sponsored family events
Bright Health sponsors family oriented events Annually.
Vacation & Time Off Benefits
Generous PTO
Paid Holidays
Paid Sick Days
Perks & Discounts
Casual Dress
Commuter Benefits
Stocked Kitchen
Happy Hours
Happy hours are hosted on occasion.
Relocation Assistance
Fitness Subsidies
Bright Health employees are eligible for discounts on several gym memberships.
Home Office Stipend for Remote Employees
Professional Development Benefits
Diversity Program
Lunch and learns
Cross functional training encouraged
Promote from within
Online course subscriptions available
Customized development tracks

Additional Perks + Benefits

Bright's primary goal is to offer employee benefits and perks that are as flexible as possible to meet each employee's unique needs!

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