Quality Risk Adjustment Advisor IV, Health Plan Experience Required

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee essential aspects of the Quality Risk Adjustment (QRA) initiatives

• Ensure adherence to regulatory requirements

• Enhance quality results

• Collaborate with internal teams and external partners

• Improve operational efficiency and utilize AI technologies

⛳️ Requirements

• A Bachelor's degree in Health Administration, Healthcare Management, or a relevant field is mandatory

• A minimum of seven (7) years of experience in risk adjustment, medical record review, coding, or quality management is required

• At least two (2) years of experience working with AI solutions in a healthcare environment is essential

• Familiarity with ICD-10 Coding is necessary

• Understanding of HCC Risk Adjustment models is important

• Awareness of CMS regulatory guidelines is required

🏝️ Benefits

• Comprehensive total rewards package

• Performance-related bonus linked to both company and individual achievements