Lead Data Analyst (Remote) - Medicare Risk Adjustment

Remote Full-time
About the position The Quality, Stars, and Risk Adjustment Analytics team is hiring a lead data analyst with deep experience in risk adjustment. This person will support the Director of Risk Adjustment by monitoring and reporting on risk adjustment KPIs, delivering insights for prospective and retrospective risk adjustment operational decisions, and working independently to improve process and data integrity. In addition, this person will work directly with vendors that supply additional data and reporting. Note: We are looking for an experienced professional to live and work remotely from within the greater Baltimore/Washington metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. Responsibilities • Engages in data exploration using various programming languages (reading and writing code), requiring advanced knowledge of multiple database structures. • Collect, analyze, and interpret data to glean insights, and develop business appropriate recommendations. • Serve as an expert resource supporting data questions and issues from stakeholders and driving to resolution. • Research and analyze data flow across complex data ecosystem including operational and analytical data platforms. • Manage the collection of business and technical requirements from stakeholders to deliver data driven solution. • Produces and reviews technical documentation that is consistent with professional standards. • Lead in the design, development, validation and delivery of data to provide insight into business decisions. • Act as a mentor to all team members. Requirements • Bachelor's Degree in Data Science, Mathematics, Computer Science, Statistics, Business or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. • 8 years experience in a progressively responsible analytical/quantitative role. Nice-to-haves • Experience in healthcare industry and deep understanding of Medicare risk adjustment (clinical, submission cycle, and financial experience). • Strong experience with SQL, Power BI, and Excel. • Skill with PowerPoint and experience presenting to a diverse set of stakeholders. • Strong project management skills and ability to manage multiple and diverse stakeholders and leadership roles. • Knowledge of claims data as found in back-end data warehouses. • Experience with Fabric or Alteryx is a plus but not required. Benefits • Comprehensive benefits package • Various incentive programs/plans • 401k contribution programs/plans Apply tot his job
Apply Now →

Similar Jobs

Database Administrator (Remote Opportunity) at Mind Computing

Remote Full-time

Clinical Informatics Lead

Remote Full-time

Clinical Informatics Analyst II, Ortho - Clinical Informatics/Information Soluti

Remote Full-time

Clinical Informatics Consultant - IntelliScript (Remote)

Remote Full-time

Healthcare Informatics Specialist

Remote Full-time

Remote Senior Health Informaticist – VA Healthcare Expert for Agile Development Teams

Remote Full-time

Healthcare Consulting Analyst - Q3 / Q4 2026 Start Dates (Spring 2026 Graduates)

Remote Full-time

Technical Solutions Consultant (Pre-Sales)

Remote Full-time

IT Healthcare Consultant – Business Analysis, Medicaid & IBM Curam

Remote Full-time

Associate Operations Director (Divisional) - Remote - Nationwide

Remote Full-time

Part-time Remote Customer Service Representative – Deliver Exceptional Travel Experiences with blithequark from the Comfort of Your Home

Remote Full-time

Senior DevOps Lead

Remote Full-time

[Part-Time Remote] Disney Data Entry Jobs – (Data Analyst)

Remote Full-time

Full Time Entry Level Insurance Sales – Amazon Store

Remote Full-time

Data Engineer 5 - Product [Remote]

Remote Full-time

Learning Program Manager – Amazon Store

Remote Full-time

Solar Sales Representative - Bonus Training Pay!

Remote Full-time

Employee Support Advisor (HR Coordinator) – Ally Home Care – Charlotte, NC

Remote Full-time

Senior React Native Developer Needed for Subscription App

Remote Full-time

Experienced Part-Time Remote Data Entry Specialist for E-Commerce Operations – Join arenaflex Team for a Dynamic and Flexible Work Experience

Remote Full-time
← Back to Home