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Senior Risk Adjustment Analyst

1 month ago

Portland, Oregon, United States Martins Point Health Care Full time
Transforming Healthcare with Data-Driven Insights

Martin's Point Health Care is seeking a highly skilled Senior Risk Adjustment Analyst to join our team. As a key member of our Risk Adjustment Operations team, you will play a critical role in analyzing data, developing recommendations, and driving revenue optimization initiatives.

Key Responsibilities:
  • Examine and perform data management analyses to develop and present performance results
  • Transfer data into meaningful formats for leadership and stakeholders
  • Review data, develop recommendations, and review findings with senior leadership
  • Analyze and extract data from the Enterprise Data Warehouse and other sources to report to internal and external customers
  • Design, develop, test, document, and maintain database queries for ad hoc reporting
  • Develop systematic reporting processes and procedures to ensure timely delivery of reports
  • Serve as a liaison between departments, including IT and Finance, for all Risk Adjustment reporting needs
  • Troubleshoot errors and data inconsistencies and coordinate resolutions to issues
  • Take a lead role in tracking progress and activities of key initiatives
  • Plan and assist with testing processes and activities, including new report or analytics methodology validation
  • Responsible for documenting and updating changes to workflow, training plans, policies, and procedures
  • Provide analytic mentorship and guidance to operational departments related to revenue optimization
  • Participate in the development of risk adjustment operational and strategic planning processes
  • Subject matter expert in CMS HCC Risk Adjustment modeling
  • May lead vendor research, software installation, configuration support, and interface development applications as needed
  • Maintain and be an expert user of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding
  • Recommend tools and methodologies that can be deployed at the organizational level, to departments, and with external partners
Requirements:
  • Bachelor's degree in Economics, Finance, Statistics, Mathematics, Actuarial Sciences, or other quantitative discipline; Master's degree preferred
  • Minimum of 5 years' experience related to reporting and analysis of healthcare data, ideally in managed care, healthcare delivery, code sets, and/or reimbursement
  • Experience in developing cost-benefit and ROI analyses

We are an equal opportunity/affirmative action employer. If you have any questions about careers at Martin's Point Health Care, please contact us at: insert contact information here