CVS Health, through Oak Street Health, is seeking a Risk Adjustment Analyst to support population health initiatives in value-based care, ACO/MSSP programs, and healthcare delivery. The role focuses on risk adjustment analytics, reporting, technical requirements, monitoring, testing, and communication with business intelligence and regional leadership teams.
Assist in the analysis, implementation, monitoring, and support ofMedicare Shared Savings Plan (MSSP) and Accountable Care Organization (ACO) programs such as LEAD, including Hierarchical Condition Category (HCC) analytics needs of the program(s)
Assist the Screening and Diagnosis Excellence (S&DE) team by supporting a wide scope of S&DE analytics and reporting
Finalize technical requirements for reporting needs / updates, collect / organize all technical requirements for the updates, and partner with Business Intelligence on development / testing / production timing
Establish communication cadence / content for regional leaders regarding bug resolution / logic additions as they are pushed into production
Create metrics and reports to monitor success and identify opportunities for improvement
Qualification
Required
The ideal candidate will have strong technical and data management skills, written and verbal communication skills, extremely detail-oriented, comfortable taking ownership & following up, be self-directed, and enjoy working with a team in a fast-paced startup environment, while bringing their experience and innovative ideas
Experience in beta testing and familiarity / knowledge of ICD-10 / HCC Model diagnosis coding framework
Strong analytics skills and proficiency in running queries in Excel
Ideal candidates will be comfortable with PowerQuery
Familiarity with the CMS HCC model and the concept of risk adjustment (RAF) scores within a value-based care system, though expertise in the way that demographic factors impact RAF is not required
Track record of effectively solving difficult problems
Orientation toward analytical problem solving
Practical, results-oriented mindset
1-2 years experience at a consulting firm or similar analytics experience
US work authorization
Bachelor's degree required
Preferred
Knowledge of SQL or GoogleSQL / BigQuery is a plus
Certifications / familiarity with Epic is a plus
Benefit
This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources, based on eligibility
CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above
CVS Health is a health solutions company that provides an integrated healthcare services to its members.
