Risk Adjustment Analyst

2 weeks ago

Tarrytown, New York, United States MVP Health Care Full time
About the Role

We are seeking a highly skilled Risk Adjustment Analyst to join our team at MVP Health Care. As a Risk Adjustment Analyst, you will play a critical role in ensuring the accuracy and integrity of our risk adjustment programs.

Key Responsibilities
  • Perform analytics and reporting on Medicare, Commercial Exchange, and Medicaid/HARP member populations
  • Provide 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
  • Calculate ROIs for Risk Adjustment programs. Maintain regulatory agency requirements for CMS and NYS related to supplemental data
Requirements
  • 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. Masters' Degree in relevant field may be considered in lieu of this experience
  • 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 Words skills, Microsoft Excel skills, and Data visualization skills (Tableau, Power BI, etc.)
  • Ability to manage multiple projects and produce results within deliverable timelines, ability to transform analytical output into simple to understand findings along with proven ability to analyze, report and provide insight on large sets of data
  • 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
What We Offer
  • 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 and one of the Best Companies to Work For in New York
Location

Location: Remote within New York State

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