Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
SCOPE OF ROLE
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 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.
- Complete data analyses focused on risk adjustment for Individual & Family Plans, Medicare Advantage, and other product lines. Perform 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 and Prescription Drug Risk Adjustment codes 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 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 understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.