Job Description

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Sun River Health provides the highest quality of comprehensive primary, preventative and behavioral health services to all who see it, regardless of insurance status and ability to pay, especially for the underserved and vulnerable. Sun River Health is a Federally Qualified, Non-Profit Health Center serving communities in Suffolk, Rockland, Orange, Dutchess, Ulster, Sullivan, Columbia, Westchester Counties and New York City.

Sun River Health is currently seeking a Senior Developer for Risk Contracting/Actuarial Reporting to join Solutions 4 Community Health, (S4CH) a wholly owned entity of Sun River Health. Solutions 4 Community Health (S4CH) provides management solutions for health care safety net providers to improve their care delivery and outcomes, sustainability and efficiency.

The Senior Developer will be responsible for data management and analysis while working with key stakeholders to understand their needs and implement them into tangible solutions using data and analytics. The Senior developer will consistently communicate with stakeholders on status updates and work closely with them in reaching their goals and needs.

Job duties:

• Interpret and analyze data from different sources including eCW and payor claims data
• Ability to work independently, with limited supervision, be resourceful and able to multitask while meeting project deadlines
• Document tech specifications and training materials

Provide initial support and day two sustainability * Implement concept knowledge in actuarial risk contract analysis such as total cost of care per member per specialty, avoidable admissions, disease management, hedis quality measures, rising risk groups, risk coding etc.

• Quantitative and qualitative analysis is needed to transform various datasets using SQL, analyze data to find patterns, discover trends, and gain insight into how that data can be used to measure risk contract performance while reducing costs and improving health outcomes.
• Must be able to communicate effectively both verbally and visually throughout department and organization regarding data, analysis results, and trends.
• Keep in contact with clients and stakeholders to obtain requirements and review results, obtain and use feedback when needed, and present data insights and suggestions
• Create, carry out data insights, plan, and identify opportunities and risks, while predicting results and meeting clients\' specific areas of need and effectively communicate to stakeholders
• Recognize and speak to unpredicted data issues to recipients and improve quality of data, while working collaboratively with IT on issues as well
• Evaluate and measure if contract terms are being fulfilled and ensure high quality outcomes from financial standpoint and patient satisfaction
• Must be organized and clear with an emphasis on attention to detail and keep track of progress efficiently

Education/Experience:
Bachelor\'s degree required; Master\'s degree preferred
Microsoft SQL certification preferred
Experience with Cognos and Spotfire, Python preferred

Medical insurance claims knowledge and or actuarial experience required

Sun River Health is a network of over 40 Federally Qualified Health Centers (FQHCs) providing primary, dental, pediatric, OB-GYN, and behavioral health care to over 245,000 patients annually. With a dedicated staff of 2,000 doctors, nurses, and health care professionals, we pride ourselves on delivering high-quality, affordable care to those who need it most. Sun River Health started in 1975 when four African American mothers spearheaded efforts to open our first health center in Peekskill, New York to deliver accessible, high-quality, affordable services to patients in need no matter their race, religion, income, or insurance status. Today, after 45 years of service, Sun River Health is still delivering on that promise to communities across the Hudson Valley, New York City, and Long Island.

Solutions 4 Community Health is growing for profit business of Sun River that employs over 100 staff that include Consultation, Project Management, Analytics and AI, IT, Training and Revenue cycle services to many clients nationwide.

Annual Salary: 140,000.00 - $150,000.00/year

Sun River Health