Senior Risk Adjustment Analyst

Job not on LinkedIn

🕒 July 21

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PACIFICSOURCE

1001 - 5000 employees

Founded 1933

Not-for-profit health plans

📋 Description

• Assist in the accurate and comprehensive data submission to regulatory entities for all risk adjustable populations • Leverage available tools and knowledge of applicable risk models to optimize data submission • Collaborate and coordinate with internal and external partners to minimize submission and response errors • Develop and improve processes related to risk adjustment and quality improvement • Maintain required documentation and ensure compliance to all applicable laws, guidance, and regulations • Provide mentorship to less experienced team members

🎯 Requirements

• Five years’ experience in data analytics or software development required • At least three years’ experience in Health Plan required • In depth risk adjustment and/or HEDIS ® experience required • Expertise in Microsoft Excel and SAS/SQL is required • Experience in leading projects and project teams required • Familiarity with Medicaid risk adjustment and CMS 5-Star required • Familiarity with Risk Adjustment Documentation, Coding practices and NCQA quality metric experience preferred

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work hours • Paid time off

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