Healthfirst

Positioned in the Finance Department, the Healthcare Analyst – Risk Score Accuracy will be responsible for supporting the risk score accuracy team through performing analyses that will validate and optimize the efficacy of our operational activities. This candidate will support and own processes that support our collaboration in the delivery system or through the vendors we have contracted with for scale. This position requires someone who is adept at problem solving, possesses strong SQL coding skills and an ability to communicate effectively to internal and external constituents. Who we are: Healthfirst was founded by a collection of major healthcare systems in the New York area to emphasize high quality of care, and better patient outcomes. We have grown into New York’s largest not-for-profit health insurer that covers members in New York City and on Long Island, as well as in Westchester, Sullivan, Orange, and Rockland counties. Healthfirst accomplishes this all while collaborating with our hospital sponsors, provider partners, and provider delivery system via our value-based model.

More about the team, and the role:

• Transactional healthcare data is the lifeline for our value-based payment model. The Risk Adjustment & Encounters Reporting team is unique, as it relies on establishing workstreams and developing partnerships across the care continuum to ensure that the member’s health status is accurately represented through encounters prior to their submission to Centers for Medicare & Medicaid Services, and the New York State Department of Health. As a Healthcare Analyst – your role will be critical towards our efforts for accurate risk scores.

You will be:

• Performing analyses that utilize multiple data sources both internal and external to support established workstreams that exist amongst our delivery system and contracted vendor partners.

• Collaborating with internal and external teams to drive efficacy in activities to improve the accuracy of our risk scores across all lines of business (Medicare Advantage, Medicaid, ACA Commercial) through our specific vendor activities as well as our key relationships across our delivery system.

• Working within the team to create efficiencies and develop automation and visualization for standard reporting for our collaborators.

Minimum Requirements:

• Bachelor’s degree from an accredited institution.

• Proficiency in SQL (Script Development, Joins) – using PostgreSQL, MS SQL Server, MySQL and Advanced MS Excel Skills (Pivot Table Creation, Complex formula development)

• Ability to communicate effectively across multiple functional areas within an organization.

• Ability to present findings and deliver actionable items as a result of findings.

Preferred Qualifications:

• Bachelor’s degree in healthcare administration or healthcare finance.

• Previous work experience within the Healthcare Industry; especially within risk adjustment (Data Analysis, Managing vendor relationships, operational workstream creation).

• Data Visualization Experience (Tableau or Qlik View or, Power BI).

• Python Scripting

Location:

• Hybrid, NY (3 days on-site at 100 Church Street, NYC 10007)

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $67,200 - $97,155

• All Other Locations (within approved locations): $59,800 - $88,910

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.