Senior Risk Adjustment Analyst

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

📋 Description

• Support the precise and thorough submission of data to regulatory authorities.

• Work together and coordinate efforts with both internal and external stakeholders.

• Identify, analyze, and interpret risk adjustment trends, and effectively communicate findings.

• Responsible for the upkeep of existing reports and the creation of new ones.

• Validate data integrity while partnering with technical teams.

• Develop and manage data sets utilizing internal data resources.

• Exhibit expertise in executing all relevant risk models.

• Maintain stringent oversight of vendor partnerships.

• Assist with all relevant audits.

• Create, maintain, and report on action metrics.

⛳️ Requirements

• A minimum of five years’ experience in data analytics or software development is required.

• At least three years’ experience in a Health Plan setting is required.

• Extensive knowledge of risk adjustment and/or HEDIS® is required.

• Proficiency in Microsoft Excel and SAS/SQL is essential.

• Experience in leading projects and managing project teams is required.

• Familiarity with Medicaid risk adjustment and CMS 5-Star is necessary.

• Knowledge of Risk Adjustment Documentation, coding practices, and NCQA quality metrics is preferred.

• A Bachelor's degree in Mathematics, Statistics, Health Informatics, or a related field is required.

• Advanced degrees are preferred.

🏝️ Benefits

• Flexible telecommuting policy.

• Medical, vision, and dental insurance coverage.

• Incentive program.

• Paid time off and holidays.

• 401(k) retirement plan.

• Opportunities for volunteering.

• Tuition reimbursement and training programs.

• Life insurance coverage.

• Options available for a flexible spending account.