Senior Risk Adjustment Analyst

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

📋 Description

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

• Work in collaboration with both internal and external stakeholders to reduce errors in submissions and responses.

• Gather and present relevant data sets effectively.

• Create and enhance processes associated with risk adjustment and quality enhancement.

• Ensure proper documentation is maintained and compliance with all relevant laws, guidelines, and regulations is upheld.

• Take on a leadership role for designated projects.

• Offer guidance and support to junior team members.

• Shape leadership decision-making by providing insights and recommendations aimed at improving risk adjustment processes.

⛳️ Requirements

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

• At least three years of experience within a Health Plan is mandatory.

• Comprehensive experience in risk adjustment and/or HEDIS ® is required.

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

• Proven experience in leading projects and managing project teams is required.

• Acquaintance with Medicaid risk adjustment and CMS 5-Star is essential.

• 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 research field is required.

• Advanced degrees are favored.

🏝️ Benefits

• Flexible telecommuting policy.

• Comprehensive medical, vision, and dental insurance.

• Incentive program.

• Paid time off and holidays.

• 401(k) retirement plan.

• Opportunities for volunteering.

• Tuition reimbursement and training opportunities.

• Life insurance coverage.

• Options available, such as a flexible spending account.