Disease Burden (HCC) Business Intelligence Developer

We are seeking ahighly analytical and detail-oriented Risk Adjustment Reporting Developerto support our organizationsMedicare Advantage ACO ACA and other risk-based programs. This role is critical inreporting trend analysis RAF analytics and provider opportunity targeting. The ideal candidate understandsCMS risk-adjustment methodologies coding impacts and can turn data insights into actionable strategies for providers CDI and clinical teams.

This position is not eligible for sponsorship at this time.

Job Summary

Partners with the business to turn data into critical information and knowledge. Possesses a fundamental understanding of healthcare and/or data and analytics. Develops reporting and analytic solutions with knowledge of the primary source data (i.e. electronic health record claims) and workflows. Develops relationships with users for direct consumption or integration with other systems. BI Developers promote data literacy by educating and training customers to use the data as an analytical tool displaying the information for the purpose of analysis and exploration. Under minimal supervision designs codes configures tests debugs deploys documents and maintains programs. Uses a variety of software development tools programming languages and testing/verification applications. Their work adheres to development best practices and quality standards. Gathers business requirements and translates the information into detailed technical specifications from which programs will be written or configured and to validate that the proposed applications align with both the architectural design and business needs. Works closely with other BIDs Data Engineers Data Scientists and internal/external customers.

Essential Functions

• Risk Adjustment Analytics & Reporting
  • Develop and deliver recurring and ad-hoc reports on RAF trends HCC capture rates provider performance and suspect lists.
  • Analyze large datasets (claims EHR encounter files) to identify gaps and missed opportunities.
  • Monitor RAF impacts HCC prevalence V28 mapping changes and quality indicators.
  • Build dashboards and visualizations usingEpic Power BI Tableau or similar tools.
  • Provide actionable insights to support coding CDI and provider education.
• Provider Targeting & Opportunity Identification
  • Create provider-level opportunity lists for chronic conditions recapture needs and care gaps.
  • Collaborate with CDI coding and provider relations teams to prioritize outreach strategies.
  • Analyze documentation trends and recommend workflow improvements.
• Trend Monitoring & Forecasting
  • Conduct year-over-year HCC trend reviews and measure program effectiveness.

Qualifications

Required

• Bachelors Degree or equivalent in business liberal arts computer science application programming software development information systems database administration mathematics engineering or related field
• 2 years of relevant experience
• EPIC Cogito Certification held within 6 months of hire

Preferred

• Prior work in payer ACO MSO or risk-bearing provider group.
• Experience in risk adjustment analytics RAF modeling or healthcare data analysis.
• Strong understanding of ICD-10-CM HCC coding V28 models and risk-adjustment methodologies.
• Ability to analyze complex datasets and present actionable insights.
• Excellent communication skills for non-technical audiences.
• Epic Certifications in Cogito Clarity and Caboodle held upon hire

About Corewell Health

As a team member at Corewell Health you will play an essential role in delivering personalized health care to our patients members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators leaders and innovators that continue to build on one shared mission statement - to improve health instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial health and work/life balance goals. Learn more here.

• On-demand pay program powered by Payactiv

• Discounts directory with deals on the things that matter to you like restaurants phone plans spas and more!

• Optional identity theft protection home and auto insurance pet insurance

• Traditional and Roth retirement options with service contribution and match savings

• Eligibility for benefits is determined by employment type and status

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Corewell Health is committed to providing a safe environment for our team members patients visitors and community. We require a drug-free workplace and require team members to comply with the MMR Varicella Tdap and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process to perform the essential functions of a job or to enjoy equal benefits and privileges of employment due to a disability pregnancy or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race color national origin sex disability age religion genetic information marital status height weight gender pregnancy sexual orientation gender identity or expression veteran status or any other legally protected category.

An interconnected collaborative culture where all are encouraged to bring their whole selves to work is vital to the health of our organization. As a health system we advocate for equity as we care for our patients our communities and each other. From workshops that develop cultural intelligence to our inclusion resource groups for people to find community and empowerment at work we are dedicated to ongoing resources that advance our values of diversity equity and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.