Systems Analyst Advisor - Commercial Risk Adjustment
Core
Analyze complex healthcare data to support Commercial Risk Adjustment CMS submissions, regulatory reporting, and federal audits while migrating legacy processes to cloud technologies.
Role type
Senior IC Systems Analyst (Healthcare Data & Regulatory Reporting)
Builds
Automated data solutions, regulatory reports, and cloud-based data workflows for CMS compliance
Domain
Healthcare / Regulatory Compliance / Data Engineering
Deliverable
production ML models | product features | dashboards & analysis | infrastructure
Required skills
SQL, SAS, data analysis, data validation, regulatory reporting, data modeling, process automation, cloud migration, troubleshooting
Preferred skills
Commercial Risk Adjustment (CMS) experience, EDGE Server submissions, Python, Spark/Snowpark, Snowflake, Microsoft SQL Server, enterprise data warehouse management
Technologies
SQL, SAS, Snowflake, Python, Spark, Snowpark, Microsoft SQL Server, EDGE Server
Responsibilities
Support end-to-end Commercial Risk Adjustment CMS submissions including data analysis and validation; Perform data analysis and validation for CMS and federal audits; Develop and maintain automated data extraction, validation, and reporting processes using SQL and SAS; Migrate legacy SQL and SAS processes to Snowflake and cloud-based technologies; Write and optimize complex SQL and SAS programs; Partner with business and IT teams to assess system changes and implement solutions
Seniority
Senior, hands-on IC