Health

Role Description The Network Manager is responsible for the strategic development, execution, and ongoing management of Habitat Health’s provider network across assigned markets and service lines. This role translates organizational network strategy into operational execution while ensuring that the provider network supports comprehensive service delivery, regulatory compliance, and high quality participant care within the PACE model. - Oversees provider contracting, provider recruitment, onboarding, and ongoing provider relationship management. - Ensures that contracted providers are successfully integrated into Habitat Health’s operational and clinical workflows. - Serves as a senior liaison between Habitat Health leadership, center operations, and external provider organizations. - Responsible for ensuring that contractual terms, regulatory expectations, billing requirements, credentialing standards, and care coordination processes are consistently implemented across the network. - Oversees network adequacy planning, supports market expansion initiatives, guides complex contract negotiations, and manages internal network development processes. - May provide supervision and guidance to network specialists or analysts responsible for supporting contracting and provider operations. - Drafts, negotiates, and manages provider contracts, amendments, single case agreements, and letters of agreement for traditional and non-traditional providers required to support a comprehensive PACE network. - Leads the development and execution of network strategy within assigned markets to ensure a comprehensive, compliant, and accessible provider network that supports the full scope of PACE services. - Identifies network gaps, service capacity needs, and strategic provider partnerships based on participant utilization patterns, geographic access requirements, regulatory standards, and program growth projections. - Establishes and maintains strategic provider relationships with key health systems, specialty providers, community-based organizations, and ancillary service partners required to support comprehensive PACE care delivery. - Oversees provider recruitment efforts across critical service areas including specialty physician services, behavioral health, home-based care, transportation, durable medical equipment, dialysis, infusion, dental, and other essential services. - Directs provider onboarding and integration activities to ensure providers understand the PACE model, authorization workflows, billing requirements, claims submission processes, and interdisciplinary care coordination expectations. - Serves as a senior escalation point for provider operational issues including claims disputes, contract interpretation, service delivery concerns, credentialing requirements, and participant care coordination challenges. - Monitors provider network performance and compliance with contractual obligations and regulatory standards and implements corrective actions or performance improvement strategies when needed. - Maintains oversight of provider and contract tracking tools to ensure accurate documentation, reporting, and regulatory readiness. - Supports cross-functional collaboration with clinical operations, finance, credentialing, compliance, and center leadership to ensure alignment between network development, operational workflows, and participant care delivery. - Supports new market launches and expansion initiatives through proactive provider recruitment, contracting strategy development, and establishment of foundational network partnerships. - Provides guidance, mentorship, and operational oversight to network specialists or other team members supporting contracting and provider relations activities. - Identifies opportunities to improve network development processes, contracting efficiency, provider onboarding, and operational integration across markets. Qualifications - Bachelor’s degree in healthcare administration, business administration, public health, or a related field required. - Master’s degree in healthcare administration, public health, business administration, or related discipline preferred. - Minimum 6 to 8 years of experience in provider contracting, network development, managed care, or health plan operations. - Demonstrated experience leading healthcare provider contract negotiations and managing provider networks within a managed care, integrated delivery, or value-based care environment. - Strong understanding of Medicare and Medicaid reimbursement methodologies, provider billing practices, and managed care contracting structures. - Experience developing and managing provider networks that support multi-service care delivery models. - Working knowledge of regulatory and compliance requirements related to provider participation within Medicare or Medicaid programs. - Proven ability to manage multiple provider relationships, contracts, and operational priorities across complex healthcare markets. - Strong written and verbal communication skills with the ability to translate contractual and regulatory requirements into operational guidance. - Demonstrated ability to build and maintain strategic relationships with health system leaders, community providers, and internal stakeholders. - Strong analytical and organizational skills with proficiency in Microsoft Excel, Word, and provider network management tools. - Ability to operate effectively in a rapidly growing organization and lead initiatives within evolving operational environments. Requirements - Prior experience working in a PACE program or with PACE providers (nice to have). - Experience with nontraditional provider types such as home and community-based services, transportation, DME, dental, behavioral health, dialysis, or infusion services (nice to have). - Familiarity with delegated credentialing models and credentialing documentation requirements (nice to have). - Experience supporting claims issue resolution or billing education for providers (nice to have). - Exposure to network adequacy reporting or provider directory management (nice to have). Benefits - Medical/dental/vision insurance. - Short and long-term disability. - Life insurance. - Flexible spending accounts. - 401(k) savings. - Paid time off. - Company-paid holidays. - Expected salary range: $106,000 - $121,000.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The People Business Partner (PBP) serves as a strategic advisor and consultant to assigned business units, supporting leaders and team members in achieving organizational objectives. This role partners closely with management to deliver value-added HR guidance, ensuring alignment with company goals and fostering a positive workplace culture. - Provide guidance and coaching to managers and team members on HR policies, procedures, and best practices. - Lead employee relations matters, including conflict resolution, investigations, and performance management. - Collaborate with leadership to identify workforce needs and implement effective talent strategies. - Support organizational change initiatives by facilitating communication and ensuring team member engagement. - Serve as a thought partner to direct leaders to strengthen Team Member (TM) engagement and retention, translating listening inputs into clear action plans and consistent follow-through. - Partner with direct leaders to identify key engagement drivers using Habitat’s engagement surveys in Culture Amp (including ENPS), stay interviews, and exit survey insights, and build targeted action plans to improve retention and team health. - Enable direct leaders to create a healthy habitat for their teams through strong 1:1s, growth and development conversations, recognition practices (e.g., Team Time “Joy in the Journey,” Habitat High-Fives, local traditions), and intentional Team Member Experience / Moments that Matter touchpoints. - Analyze HR metrics and trends to recommend solutions, programs, and policies to drive business results. - Partner with People Operations team to ensure compliance with all employment laws and company policies. - Partner with the Talent Acquisition team to proactively identify backfill needs, support recruitment and onboarding processes. Qualifications - Aligns with our purpose and our values, and is excited about living those out in daily practice. - Ability to lead with influence. - Bachelor’s degree in Human Resources, Business Administration, or related field strongly preferred. - 4+ years of progressive HR experience, preferably in a business partner role. - Strong knowledge of employment law and HR best practices. - Excellent interpersonal, communication, and influencing skills. - Proven ability to work independently and as part of a team in a fast-paced environment. - Demonstrated problem-solving and analytical abilities. Requirements - HR Certification (Nice to have). Benefits - Medical/dental/vision insurance. - Paid parental leave (birthing and non-birthing parents). - Short and long-term disability. - Life insurance. - Flexible spending accounts. - 401(k) savings. - Paid time off. - Company-paid holidays. - Expected salary range: $110,000 - $128,000 and is bonus eligible. Vaccination Policy, including COVID-19 At Habitat Health, we aim to provide safe and high-quality care to our participants. To achieve this, please note that we have vaccination policies to keep both our team members and participants safe. For covid and flu, we require either proof of vaccination or declination form and required masking while in participant locations as a safe as an essential requirement of this role. Requests for reasonable accommodations due to an applicant’s disability or sincerely held religious beliefs will be considered and may be granted based upon review. We also require that team members adhere to all infection control, PPE standards and vaccination requirements related to specific roles and locations as a condition of employment. Our Commitment to Diversity, Equity, and Inclusion Habitat Health is an Equal Opportunity employer and is committed to creating a diverse and inclusive workplace. Habitat Health applicants are considered solely based on their qualifications, without regard to race, color, religion, creed, sex, gender (including pregnancy, childbirth, breastfeeding or related medical conditions), gender identity, gender expression, sexual orientation, marital status, military or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), or other status protected by applicable law. Habitat Health is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Habitat Health will take steps to provide people with disabilities and sincerely held religious beliefs with reasonable accommodations in accordance with applicable law. Accordingly, if you require a reasonable accommodation to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact us at careers@habitathealth.com. Beware of Scams and Fraud Please ensure your application is being submitted through a Habitat Health sponsored site only. Our emails will come from @habitathealth.com email addresses. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission by selecting the ‘Rip-offs and Imposter Scams’ option: https://reportfraud.ftc.gov/#/ .

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Our Health Plan is looking for a detail oriented, process driven individual to join our team with deep knowledge of claims processing and utilization management to provide strategic leadership and operational oversight to shape a vital subfunction at our organization. This role will build scalable processes to ensure the accuracy, timeliness, and quality of service authorizations, claims adjudication, and encounter data by conducting retrospective reviews, maintaining robust reporting, and overseeing daily operational performance. It collaborates across functions to resolve data discrepancies, monitor inventory and production stability, and provide leadership with actionable insights that drive continuous process improvement. - Sets the vision, operating standards, and governance framework for Part C authorizations, claims processing (including TPA oversight), and encounter data operations, ensuring regulatory compliance and operational consistency. - Oversees day-to-day adjudication operations, ensuring a controlled, disciplined, regulatorily compliant and exceptionally reliable operational environment that is timely, accurate, and has a high-quality output by internal team members and external vendors, as necessary. - Responsible for establishing and maintaining and evolving reports and performance management frameworks, including KPIs, audit outcomes, utilization metrics, and risk indicators, and communicate insights to senior leadership. - Owns end-to-end encounter data processing including reviewing and monitoring encounter data submissions for accuracy, ensuring discrepancies are identified, corrected, and communicated through collaboration with crossfunctional teams; maintaining documentation and troubleshooting processes to support data quality. - Engages with Enrollment & Eligibility to resolve data discrepancies impacting member benefits or provider assignments. Partners with Provider Network on contract load timing, unclear terms, and pricing interpretation issues. - Conducts retrospective reviews and maintains reporting that evaluates the accuracy, timeliness, and effectiveness of service authorization processes, providing clear summaries of findings and outcomes to leadership to drive continuous improvement. - Monitors daily, weekly, and monthly inventory at the claim, and authorization and encounter data level to anticipate risk and maintain a stable production environment. Qualifications - 8+ years of experience in health insurance operations, including team leadership and direct supervisory experience. - Demonstrated expertise in claims processing and utilization management. - Background in capitated health plan financials; PACE experience strongly preferred. - Strong customer service orientation and ability to handle confidential information. - Excellent verbal and written communication skills. - Bachelor’s degree in healthcare, finance, or related field required; Master’s degree preferred. - Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint). Requirements - Vaccination Policy, including COVID-19: At Habitat Health, we aim to provide safe and high-quality care to our participants. To achieve this, please note that we have vaccination policies to keep both our team members and participants safe. For covid and flu, we require either proof of vaccination or declination form and required masking while in participant locations as a safe as an essential requirement of this role. Requests for reasonable accommodations due to an applicant’s disability or sincerely held religious beliefs will be considered and may be granted based upon review. We also require that team members adhere to all infection control, PPE standards and vaccination requirements related to specific roles and locations as a condition of employment. Compensation - We consider an individual’s qualifications, skillset, and experience in determining final salary. - This role is eligible for health insurance, life insurance, participation in the company’s equity program, and paid time off, including vacation and sick leave. - The expected salary range for this position is $153,000 to $170,000. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. Our Commitment to Diversity, Equity, and Inclusion - Habitat Health is an Equal Opportunity employer and is committed to creating a diverse and inclusive workplace. - Habitat Health applicants are considered solely based on their qualifications, without regard to race, color, religion, creed, sex, gender (including pregnancy, childbirth, breastfeeding or related medical conditions), gender identity, gender expression, sexual orientation, marital status, military or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), or other status protected by applicable law. - Habitat Health is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Habitat Health will take steps to provide people with disabilities and sincerely held religious beliefs with reasonable accommodations in accordance with applicable law. Contact Information If you are interested in this position, please contact careers@habitat.com with “Habitat Health | Director, Accounting” and your name in the subject line. Please include a resume, and anything else that you feel will help us understand you and your interest in Habitat Health.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are looking for a qualified, hands-on Information Security Manager to design, implement, and operate the information security program for our growing healthcare organization operating under the PACE model. This role blends strategic security leadership with practical execution. The ideal candidate can translate high regulatory and partner security standards into right-sized, pragmatic controls, while building sustainable governance, oversight, and audit processes. - Deploy HIPAA aligned best practice security architecture across our Microsoft 365 environment and Meraki based WAN. - Define, implement, and maintain administrative, technical, and physical security controls appropriate for a PACE organization. - Own security design decisions and control selection, balancing risk, regulatory requirements, and operational realities. - Security monitoring and incident response: configure and monitor tools, logs, and alerts, analyze activity, and investigate potential security incidents. - Serve as primary security escalation point for internal teams and external partners. - Lead incident response planning, tabletop exercises, post-incident reviews, and remediation tracking. - Perform vulnerability management activities, based on internal and external scans, and coordinate remediation activities. - Maintain an enterprise security risk register, including risk scoring, mitigation plans, and executive-level reporting. - Support business continuity and disaster recovery security requirements in partnership with IT and Operations. - Lead Access and Identity management, developing best practice procedures, and enabling others to work within these processes. - Oversee privileged access, role-based access controls, joiner/mover/leaver processes, and periodic access reviews. - Ensure appropriate data protection controls for PHI, including encryption, logging, and monitoring. - Draft, maintain, and enforce security policies, standards, and procedures aligned to HIPAA, NIST, and partner requirements. - Design and operate recurring security oversight and audit processes, including evidence collection and remediation tracking. - Lead and coordinate internal and external security audits, assessments, and partner security reviews. - Establish and manage a third-party security and risk management program, including vendor risk assessments and ongoing monitoring. - Partner closely with IT, Compliance, Legal, Clinical, and Operations teams to embed security into daily workflows. Qualifications - Bachelor’s degree in Computer Science with an emphasis on Information Security, or equivalent experience. - 7+ years of progressive experience in information security or cybersecurity roles, including hands-on implementation. - 3–5 years of experience owning or leading security programs, controls, or governance functions. - Hands-on experience in implementing information security best practices, and experience with security monitoring, incident response, or vulnerability management. - Practical experience in a Health Care organization, and expertise in industry regulatory and standards frameworks (HIPAA, NIST, etc). - Experience in cloud-based environments, specifically Microsoft 365. - Experience in networking concepts, operating systems, and cloud environments. - Familiarity with regulatory and standards frameworks (HIPAA, NIST, etc.). - Strong analytical and problem-solving skills with attention to detail. - Ability to lead through influence. - Ability to communicate complex issues clearly to technical and non-technical audiences. - Ability to travel up to 2 weeks per quarter. Requirements - Experience in a start-up organization. - Experience supporting audits, partner security assessments, or SOC/HIPAA readiness efforts. - Experience in creating technology solutions based on business requirements. - Experience working remotely – this is a remote position. - Professional certifications such as CISSP, CISM, CISA, or Security+ (preferred, not required). - A strong connection to the mission of our business. - Experience working with technology managed service providers. Benefits - This role is eligible for medical/dental/vision insurance. - Paid parental leave (birthing and non-birthing parents). - Short and long-term disability. - Life insurance. - Flexible spending accounts. - 401(k) savings. - Paid time off. - Company-paid holidays. - The expected salary range for this position is $133,000 - $157,000.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are looking for a Project Manager to oversee and lead individual jobs/projects from application approval through State Readiness Review (SRR) and handover to the Operations Team. The primary purpose of this position is to ensure new facilities are delivered within established timelines and budgetary constraints. An ideal candidate can effectively track project delivery through multiple phases, work with external contractors and internal stakeholders, and ensure a seamless transition from initial site planning to state approval and handover to operations. - Oversee projects to maintain schedule and ensure projects are completed in the allotted time frame - Hands-on installation of clinical and administrative equipment and supplies necessary for a functioning PACE center - Responsible for driving project progress internally and externally - Proactively monitor, track and take necessary action to identify and mitigate risks and deliver projects at or below estimated cost - Determine project schedule from initiation through handover - Coordinate with other departments to execute each phase of the project - Deliver excellent customer service throughout the project - Meet with contractors and partners when needed - Identify and escalate any necessary design changes or change orders Qualifications - Min of 4 years experience in project management - Ability to drive process and affect results internally and externally - Ability to work collaboratively with inter-disciplinary team - Ability to be on site and handle delivery/installation of equipment and supplies - Excellent organizational and multi-tasking abilities - Ability to make decisions and use discretion - Customer service and partnership driven - Strong interpersonal and communication skills - Proficient in Microsoft Office 360 - Ability to lift and/or move boxes weighing up to 40 pounds Requirements - Nice to have: Construction experience - Knowledge of PACE or ADHC/CBAS - Background in healthcare administration Benefits - Medical/dental/vision insurance - Paid parental leave (birthing and non-birthing parents) - Short and long-term disability - Life insurance - Flexible spending accounts - 401(k) savings - Paid time off - Company-paid holidays - Expected salary range: $75,000 - $96,000 Vaccination Policy, including COVID-19 At Habitat Health, we aim to provide safe and high-quality care to our participants. To achieve this, please note that we have vaccination policies to keep both our team members and participants safe. For COVID and flu, we require either proof of vaccination or declination form and required masking while in participant locations as a safe and essential requirement of this role. Requests for reasonable accommodations due to an applicant’s disability or sincerely held religious beliefs will be considered and may be granted based upon review. We also require that team members adhere to all infection control, PPE standards and vaccination requirements related to specific roles and locations as a condition of employment. Our Commitment to Diversity, Equity, and Inclusion Habitat Health is an Equal Opportunity employer and is committed to creating a diverse and inclusive workplace. Habitat Health applicants are considered solely based on their qualifications, without regard to race, color, religion, creed, sex, gender (including pregnancy, childbirth, breastfeeding or related medical conditions), gender identity, gender expression, sexual orientation, marital status, military or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), or other status protected by applicable law. Habitat Health is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Habitat Health will take steps to provide people with disabilities and sincerely held religious beliefs with reasonable accommodations in accordance with applicable law. Accordingly, if you require a reasonable accommodation to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact us at careers@habitathealth.com. Beware of Scams and Fraud Please ensure your application is being submitted through a Habitat Health sponsored site only. Our emails will come from @habitathealth.com email addresses. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission by selecting the ‘Rip-offs and Imposter Scams’ option: https://reportfraud.ftc.gov/#/ .

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Use SQL to analyze clinical, operational, financial, and administrative data generated in Epic’s electronic health record (EHR) and practice management (PM) systems and stored in Epic’s back-end Clarity data model. - Leverage Epic’s in-app reporting tools including Slicer Dicer, Reporting Workbench (RWB), and Radar to answer data questions from internal Habitat customers in the simplest / easiest / most scalable way possible. - Enable leadership to make evidence-based decisions by designing, building, and maintaining business intelligence dashboards and data pipelines using tools such as Power BI, SQL, and Git. - Work with engineering to design and develop ETL processes that support consistent KPI reporting via Data Marts with clear documentation that codifies our standard “business rules” layer. - Develop rigorous data quality tests, QC best practices, code reviews / Git pull requests, dashboard release processes, and proper documentation to ensure your work is accurate and clearly communicated. - Develop detailed clinical logic and code sets for patient cohorts and quality measures including diagnosis groupers, hospital admissions, readmissions, ED visits, SNF visits etc. across a wide range of clinical facts and dimensions. - Build externally facing reports including PACE-specific measures and CMS / Medicaid regulatory and audit reporting in a scalable manner. - Work closely with other data team members to ensure you benefit from all the great work happening around you! Qualifications - 3+ years of experience working directly with Epic’s Clarity data model. - Highly proficient coding in SQL; experience with Git is a plus. - Strong understanding of healthcare data ontologies including CPT, HCPCS, HCC, ICD-10, NDC, Revenue Codes, Type of Bill, LOINC, UB/HCFA claims, etc. - Experience developing longitudinal patient analyses using complex clinical logic. - Demonstrated experience building dashboards and reports in Power BI or similar platforms. - Excellent communication skills; able to explain technical concepts to non-technical stakeholders. - Track record of working in cross-functional teams, ideally in a value-based care, PACE, or managed care environment. - Strong attention to detail and data quality, with a mindset toward reproducibility and documentation. Requirements - Familiarity with Epic Workflows and Clarity reporting tools, like Slicer Dicer, Reporting Workbench, and Cogito SQL. - Experience developing in a modern data stack using Databricks, Python, and/or Airflow. - Experience working in early-stage or rapidly scaling healthcare organizations. - Experience with Medicare Advantage, PACE, and/or dual eligible populations. Compensation We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for medical/dental/vision insurance, short and long-term disability, life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays. The expected salary range for this position is $90,000- $105,000 and is bonus-eligible. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. Vaccination Policy, including COVID-19 At Habitat Health, we aim to provide safe and high-quality care to our participants. To achieve this, please note that we have vaccination policies to keep both our team members and participants safe. For covid and flu, we require either proof of vaccination or declination form and required masking while in participant locations as a safe as an essential requirement of this role. Requests for reasonable accommodations due to an applicant’s disability or sincerely held religious beliefs will be considered and may be granted based upon review. We also require that team members adhere to all infection control, PPE standards and vaccination requirements related to specific roles and locations as a condition of employment. Our Commitment to Diversity, Equity, and Inclusion Habitat Health is an Equal Opportunity employer and is committed to creating a diverse and inclusive workplace. Habitat Health applicants are considered solely based on their qualifications, without regard to race, color, religion, creed, sex, gender (including pregnancy, childbirth, breastfeeding or related medical conditions), gender identity, gender expression, sexual orientation, marital status, military or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), or other status protected by applicable law. Habitat Health is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Habitat Health will take steps to provide people with disabilities and sincerely held religious beliefs with reasonable accommodations in accordance with applicable law. Accordingly, if you require a reasonable accommodation to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact us at careers@habitathealth.com. Beware of Scams and Fraud Please ensure your application is being submitted through a Habitat Health sponsored site only. Our emails will come from @habitathealth.com email addresses. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission by selecting the ‘Rip-offs and Imposter Scams’ option: https://reportfraud.ftc.gov/#/ .

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are seeking a Principal Data Analyst to serve as a technical and analytical leader across our healthcare data ecosystem. This role goes far beyond report building - you will define analytic standards, design core data models, and own the clinical and financial logic that leadership relies on to run the business working across Epic Clarity, medical claims, pharmacy claims, and other core data assets. This is a hands-on, senior-level individual contributor role for someone who combines deep Epic expertise with strong healthcare domain knowledge and modern analytics / engineering practices. - Master enterprise-level analytics across Habitat’s Epic Clarity, medical claims, pharmacy claims, and related healthcare and operational data assets. - Translate complex clinical and financial questions into durable, scalable analytic solutions designed and developed with a “platform-first mentality” to enable other developers. - Support executive and clinical leadership decision-making by designing, building, and maintaining trusted dashboards, KPI definitions, and “curated” analytic DataMarts. - Use SQL, Power BI, Git, and Jira in a manner that raises the bar and sets the standards for best practices within the broader data team. - Partner with data engineering to design and govern canonical data marts, ETL processes, and documented business rules that ensure consistency across all downstream analytics. - Develop and maintain rigorous clinical and claims-based logic for longitudinal patient analyses, quality measures, utilization metrics, and value-based care performance. - Lead data quality, testing, documentation, and code review standards to ensure analytics are accurate, auditable, reproducible, and production-ready. - Build and maintain externally facing regulatory and audit reporting (CMS, Medicaid, PACE) in a scalable and defensible manner. - Act as a technical leader and mentor within the data team, elevating analytic rigor and best practices without formal people management. Qualifications - 10+ years of hands-on experience as an analyst / leader in healthcare data analytics. - Expert level mastery of Epic Clarity and/or medical claims datasets. - Advanced SQL skills, including complex joins, window functions, performance optimization, and readable, maintainable query design. - Experience designing and building enterprise-grade dashboards with drill-down functionality in Power-BI or another data visualization tool. - Deep understanding of healthcare data ontologies including CPT, HCPCS, HCC, ICD-10, NDC, Revenue Codes, Type of Bill, LOINC, UB/HCFA claims, etc. - Proven experience developing longitudinal patient analyses using complex clinical logic, while interfacing with subject matter experts like MDs, Pharm-Ds, epidemiologists, etc. - Excellent communication skills; able to explain technical concepts to non-technical stakeholders at a high level with all the supporting documentation in your back pocket. - Track record of working in cross-functional teams, ideally in a value-based care, PACE, or managed care environment. - A team first mentality within our team; a company first mentality when working across Habitat teams. Requirements - Experience developing in a modern data stack using Databricks, Python, and/or Airflow. - Experience working in early-stage or rapidly scaling healthcare organizations. - Experience with Medicare Advantage, PACE, and/or dual eligible populations. Benefits - This role is eligible for medical/dental/vision insurance. - Short and long-term disability. - Life insurance. - Flexible spending accounts. - 401(k) savings. - Paid time off. - Company-paid holidays. - The expected salary range for this position is $146,000 - $170,000 and is bonus-eligible.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are looking for a Certified Risk Adjustment Coder who is passionate about supporting accurate and compliant documentation for our PACE participants. This role requires a self-starter who thrives in an independent, remote environment, with strong critical thinking skills and a drive to deliver the highest quality outcomes. The ideal candidate will have hands-on expertise in both CMS-HCC v24 and v28 models and the ability to apply coding standards across multiple workflows. - Review participant medical records and provider documentation to identify, validate, and code risk-adjustable diagnoses in accordance with CMS-HCC v24 and v28 guidelines. - Ensure complete, accurate, and compliant ICD-10-CM coding with a primary focus on concurrent and retrospective reviews (with flexibility for pre-visit planning as needed). - Draft and submit compliant provider queries to clarify documentation and support accurate coding. - Track and follow through on open queries—engaging with providers, monitoring responses, and closing them out appropriately. - Apply strong critical thinking skills to resolve complex documentation and coding scenarios. - Maintain clear, professional communication with providers and internal teams to support documentation completeness. - Stay current with CMS, OIG, and industry regulations related to risk adjustment and coding compliance. Qualifications - Active CRC (Certified Risk Adjustment Coder) required. - Minimum of 1 year of experience in risk adjustment coding. - In-depth knowledge of ICD-10-CM and CMS-HCC models v24 and v28. - Demonstrated ability to work independently, stay organized, and follow through on tasks with minimal oversight. - Strong written and verbal communication skills, with the ability to engage providers in a professional and solutions-oriented manner. - High attention to detail and ability to critically analyze clinical documentation. - Proficiency with electronic health records (EHR) and Microsoft Excel. - Aligns with our purpose and our values, and is excited about living those out in daily practice. Requirements - Experience as a risk adjustment coder in PACE, long-term care, or complex care populations (nice to have). - Background in clinical documentation improvement (CDI) or coding quality assurance (nice to have). - Experience with Epic/OCHIN systems (nice to have). Benefits - Medical/dental/vision insurance. - Short and long-term disability. - Life insurance. - Flexible spending accounts. - 401(k) savings. - Paid time off. - Company-paid holidays. - Expected salary range: $24-$27 hourly and is bonus eligible.