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 bodies for all populations subject to risk adjustments.

• Utilize available tools and understanding of relevant risk models to enhance data submission processes.

• Collaborate and coordinate with both internal and external stakeholders to reduce submission and response inaccuracies.

• Develop and refine processes associated with risk adjustment and quality enhancement.

• Keep necessary documentation up to date and ensure adherence to all relevant laws, guidelines, and regulations.

• Mentor less experienced team members to foster their professional growth.

⛳️ Requirements

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

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

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

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

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

• Familiarity with Medicaid risk adjustments and CMS 5-Star is essential.

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

🏝️ Benefits

• Health insurance

• 401(k) matching

• Flexible work hours

• Paid time off