Risk Adjustment Analyst
2 days ago
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 analyzing and interpreting large data sets to identify opportunities for growth and improvement in our healthcare services.
Key Responsibilities- Perform advanced 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 and maintain regulatory agency requirements for CMS and NYS related to supplemental data
- 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.)
- 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
- 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
Remote within New York State
Pay TransparencyAt 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 ActionMVP is an Affirmative Action/Equal Employment Opportunity (EEO) employer. 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.
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