Summary Of Job
Provide complex analytical and reporting/data mining support to the Risk Adjustment Department for Medicare, Medicaid and HIX products. Perform data and analytical services in support of optimizing risk adjusted revenue, maintaining compliance with CMS standards and modeling financial impacts of changes in risk adjustment data and methodologies. Must have strong Risk Adjustment experience/knowledge. Collaborate regularly with internal departments, including but not limited to: Finance, Medicare Operations, Network Management, Provider Contracting, and Health Economics, and external vendors on risk adjustment projects. Organize, prioritize, and manage various simultaneous tasks/projects to meet deadlines. Understand various areas of the business and operational processes relevant to the project’s goals. Provide technical support to leadership on prospective risk adjustment programs. Assist in performing analyses used in the development of financial plans, re-forecasts, and other financial projections. Work on identifying gaps in the claims, encounter reconciliation process, and provide insights to educate providers. Build reports and dashboards to track risk adjustment related projects and to track the effectiveness of the initiatives. **
Responsibilities**
Qualifications
Additional Information
Computer Futures
Digi
SynergisticIT
Aspire nexus
CI&T