Senior Analyst, Risk Adjustment - Predictive Analytics - RADV Audits/Databricks/SQL/Python - Remote - Molina Healthcare : Job Details

Employer Industry: Healthcare AnalyticsWhy consider this job opportunity:- Opportunity to work on impactful Risk Adjustment Data Validation (RADV) projects within the healthcare sector- Competitive benefits and compensation package- Collaborate with cross-functional teams, enhancing teamwork skills and professional relationships- Chance to contribute to regulatory and clinical compliance initiatives- Engage in a dynamic work environment that encourages problem-solving and analytical thinkingWhat to Expect (Job Responsibilities):- Support RADV audit execution by identifying data sources, validating CMS audit samples, and generating chart retrieval chase lists- Analyze structured and unstructured data sets using Databricks SQL and other tools to confirm necessary data elements for audits- Collaborate with internal stakeholders to ensure accurate data sourcing and alignment with audit requirements- Document methodology and data sourcing logic to maintain audit traceability and facilitate knowledge sharing- Investigate data inconsistencies and perform root cause analysis to identify potential data gaps or operational improvementsWhat is Required (Qualifications):- Bachelor's Degree in Computer Science, Finance, Math, Economics, or equivalent discipline- 3-5 years of experience with healthcare-related data (claims, provider data, CMS/EDGE response files, etc.)- 3-5 years of experience with advanced SQL-based analytics (procedures, window functions, dynamic SQL, etc.)- 3-5 years of experience working with Databricks for analytics and workflows- 1-3 years of programming experience in Python to support automated data validation and processingHow to Stand Out (Preferred Qualifications):- Experience in health plan Risk Adjustment analytics- Core database fundamentals (Primary/Foreign Keys, Relational Databases, Normalization, Transactions, etc.)#HealthcareAnalytics #RiskAdjustment #DataValidation #SQL #Python #CareerOpportunityWe prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.