Risk Adjustment Analyst

4 weeks ago

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

We are seeking a 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 based on disparate data sources to identify members with likely risk gaps.
  • 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.
  • 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.
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.
  • 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.
About MVP Health Care

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.

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