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Risk Adjustment Analyst
2 months ago
We are seeking a highly skilled Risk Adjustment Analyst to join our team at MVP Health Care. As a key member of our team, you will be responsible for performing analytics and reporting on Medicare, Commercial Exchange, and Medicaid/HARP member populations.
Key Responsibilities- Performing analytics and reporting on member populations to identify risk gaps and opportunities for improvement.
- Designing targeting strategies to identify members with likely risk gaps across disparate data sources.
- Providing regular reporting of Risk Adjustment programs and identifying opportunities and obstacles.
- Measuring capture rate of Hierarchical Condition Categories (HCCs) and diagnosis codes related to Risk Adjustment programs to improve and optimize program targeting.
- Using Clinical Risk Group (CRG) software to target interventions for improved coding for Medicaid members.
- Calculating ROIs for Risk Adjustment programs and maintaining regulatory agency requirements for CMS and NYS.
- Bachelor's Degree in Health Administration, Business, Economics, Health Informatics, or related field.
- One year experience in a business or healthcare environment involving the analysis of financial or other large data sets.
- Demonstrated problem-solving, analytical abilities, and ability to work independently with strong attention to detail, and written and verbal communication skills.
- Intermediate SQL skills, Microsoft Word skills, Microsoft Excel skills, and Data visualization skills (Tableau, Power BI, etc.).
MVP Health Care is a mission-driven organization committed to creating a healthier future for everyone. We are a Best Place to Work for and one of the Best Companies to Work For in New York. We offer a competitive compensation and comprehensive benefits package, as well as opportunities for growth and development.
