Risk Adjustment Analyst

2 weeks ago

Schenectady, United States MVP Health Care Full time
Risk Adjustment Analyst

Headquarters Office, 625 State Street, Schenectady, New York, United States of America • Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America • Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America Req #2173

Wednesday, September 4, 2024

At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a Risk Adjustment Analyst to join #TeamMVP. This is the opportunity for you if you have a passion for making data driven decisions, data analytics and driving real outcomes for MVP through risk adjustment.

What's in it for you:
  • Growth opportunities to uplevel your career
  • A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team
  • Competitive compensation and comprehensive benefits focused on well-being
  • An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work for and one of the Best Companies to Work For in New York

Qualifications you'll bring:
  • Bachelor's Degree Health Administration, Business, Economics, Health Informatics, or related field
  • The availability to work full-time, virtual in New York State
  • One year experience in a business environment involving the analysis of financial or other large data sets. Masters' Degree in relevant field may be considered in lieu of this experience
  • Previous Health Insurance experience preferred
  • Demonstrated problem-solving and analytical abilities
  • Intermediate SQL skills
  • Demonstrated ability to work independently with strong attention to detail, and written and verbal communication skills
  • Ability to manage multiple projects and produce results within deliverable timelines
  • Ability to transform analytical output into simple to understand findings
  • Intermediate Word skills, including the ability to create moderately complex documents containing tables and graphs
  • Intermediate Microsoft Excel skills, including the ability to create simple formulas, insert rows, link data, enter and sort data and produce graphs and charts
  • Proven ability to analyze, report and provide insight on large sets of data
  • Data visualization skills (Tableau, Power BI, etc.)
  • Curiosity to foster innovation and pave the way for growth
  • Humility to play as a team
  • Commitment to being the difference for our customers in every interaction

Preferred Skills:
  • Knowledge of MAO-002, MAO-004, RAPS
  • R or Python

Your key responsibilities:

  • Performing analytics and reporting on Medicare, Commercial Exchange, and Medicaid/HARP member populations
  • Analytical support on various prospective and retrospective objectives in population health management including focus on Risk Adjustment efforts
  • Design targeting based upon disparate data sources to identify members with likely risk gaps across
  • Provide regular reporting of Risk Adjustment programs and identify opportunities and obstacles
  • Measure capture rate of Hierarchical Condition Categories (HCC)s and diagnosis codes related to Risk Adjustment programs to improve and optimize program targeting for Medicare and commercial exchange populations
  • Use Clinical Risk Group (CRG) software to target interventions for improved coding for Medicaid members
  • Calculates ROIs for Risk Adjustment programs. Maintain regulatory agency requirements for CMS and NYS related to supplemental data
  • Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.

Where you'll be:

Virtual based in New York State

Pay Transparency
At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.

Affirmative Action
MVP is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com .

Other details
  • Job Family Finance/Accounting
  • Pay Type Salary
  • Min Hiring Rate $69,383.00
  • Max Hiring Rate $105,000.00

  • Risk Adjustment Analyst

    3 days ago

    Schenectady, New York, United States MVP Health Care, Inc. Full time

    About the RoleWe are seeking a highly skilled Risk Adjustment Analyst to join our team at MVP Health Care, Inc. As a key member of our organization, you will play a critical role in analyzing and interpreting large data sets to inform business decisions and drive growth.Key ResponsibilitiesAnalytics and Reporting: Perform in-depth analysis and reporting on...

  • Risk Adjustment Specialist

    1 week ago

    Schenectady, New York, United States MVP Health Care Full time

    Job SummaryMVP Health Care is seeking a highly skilled Risk Adjustment Analyst to join our team. As a Risk Adjustment Analyst, you will play a critical role in helping us achieve our mission to create a healthier future for everyone.Key ResponsibilitiesPerform advanced analytics and reporting on Medicare, Commercial Exchange, and Medicaid/HARP member...

  • Risk Adjustment Analyst

    1 week ago

    Schenectady, New York, United States MVP Health Care, Inc. Full time

    About the RoleWe are seeking a highly skilled Risk Adjustment Analyst to join our team at MVP Health Care, Inc. As a Risk Adjustment Analyst, you will play a critical role in analyzing and reporting on Medicare, Commercial Exchange, and Medicaid/HARP member populations.Key ResponsibilitiesPerform advanced analytics and reporting on large data sets to...

  • Associate, Risk Adjustment Coder

    4 weeks ago

    Schenectady, United States MVP Health Care Full time

    Job DescriptionAssociate, Risk Adjustment CoderHeadquarters Office, 625 State Street, Schenectady, New York, United States of America • Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America • Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America • Virtual Req #2140Wednesday, August 14, 2024At...

  • Nurse Practitioner NP or Physician Assistant PA-C, Part-Time, HRA

    3 months ago

    Schenectady, United States Hueman Risk Adjustment Full time

    Job DescriptionJob DescriptionHueman is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Schenectady, NY. This unique opportunity adapts to your lifestyle, giving you the freedom to achieve your professional goals on your terms, all while enjoying...

  • Nurse Practitioner NP or Physician Assistant PA-C, Part-Time, HRA

    3 months ago

    Schenectady, United States Hueman Risk Adjustment Solutions Full time

    Description Hueman is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Schenectady, NY. This unique opportunity adapts to your lifestyle, giving you the freedom to achieve your professional goals on your terms, all while enjoying a schedule...

  • IT Portfolio Analyst

    3 months ago

    Schenectady, United States Genesis Consulting Partners, LLC Full time

    Job DescriptionJob DescriptionThis is a remote position.Job Type: Full-Time Job Location: Remote, Potential on-site visits for client meetings as needed. Job Summary: The IT Business Analyst will play a pivotal role in supporting the project leadership team for a strategic IT organization transformation project for a Federal Healthcare client). As a crucial...

  • Actuary Analyst

    3 weeks ago

    Schenectady, United States MVP Health Care Full time

    Actuary AnalystHeadquarters Office, 625 State Street, Schenectady, New York, United States of America • Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America • Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America Req #1932Thursday, August 22, 2024Over 35 years strong and fueled by 1,700 smart,...

  • Growth Enablement Analyst

    3 months ago

    Schenectady, United States MVP Health Care Full time

    Growth Enablement AnalystHeadquarters Office, 625 State Street, Schenectady, New York, United States of America Req #2059Thursday, June 6, 2024Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The...

  • Actuary Analyst

    3 weeks ago

    Schenectady, United States MVP Health Care Full time

    Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working...

  • Nuclear Medicine Imaging Professional

    1 week ago

    Schenectady, New York, United States Ellis Medicine Full time

    Overview:The Nuclear Medicine Technologist at Ellis Medicine operates under the guidance of the Director of Radiology and collaborating Radiologists. This role involves the application of radionuclides and radiopharmaceuticals to conduct diagnostic imaging examinations, which encompass organ imaging, dynamic studies, and assays of bodily fluids and...

  • Radiology Nuclear Medicine Specialist

    1 week ago

    Schenectady, New York, United States Ellis Medicine Full time

    Overview:The Nuclear Medicine Technologist at Ellis Medicine operates under the general oversight of the Director of Radiology and collaborating Radiologists. This role involves the application of radionuclides and radiopharmaceuticals to conduct diagnostic evaluations, including imaging of various organs and systems, dynamic studies, and assays of bodily...

  • Licensed Mental Health Counselor

    2 months ago

    Schenectady, United States Ithaca City School District Full time

    Position works 10 A.M. - 6 P.M. Monday - Friday DISTINGUISHING FEATURES OF THE CLASS : The work involves responsibility for coordinating mental health care services and treatment planning in a public school. The incumbent assesses mental health concerns and recommends therapeutic and corrective measures while collaborating with families and outside...

  • Senior Government Operations Specialist

    2 weeks ago

    Schenectady, New York, United States GE Renewable Energy Power and Aviation Full time

    Job Description SummaryThe Senior Government Operations Specialist is a key individual contributor responsible for overseeing the US Government funded initiatives at GE Renewable Energy Power and Aviation. This role necessitates a strong background in financial strategy, data analytics, and compliance with various regulatory frameworks for diverse contract...

  • Associate, Chart Procurement Specialist

    4 weeks ago

    Schenectady, United States MVP Health Care Full time

    Associate, Chart Procurement Specialist 220 Alexander St, Rochester, NY 14607, USA * 303 S Broadway # 230, Tarrytown, NY 10591, USA * 625 State St, Schenectady, NY 12305, USA Req #2142Thursday, August 8, 2024Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a...

  • Case Manager

    2 months ago

    Schenectady, United States Ellis Medicine Full time

    What Will You Do? 1. To be responsible for the comprehensive integration of Discharge Planning, Performance Improvement and Utilization Review activities at patient, hospital, and system levels. 2. Efficiently and effectively ensures the anticipation, identification, and resolution of issues through pre-admission, admission, concurrent and post discharge...