A bit about us:
Were on a mission to change healthcare how its paid for, delivered, experienced. We want to put people center stage, not process or profit. We are guided by a deep belief that every person on Medicare should be treated like we would treat a member of our own family: with loving care and a profound commitment to their health and well-being.
Thats why were gathering a whole bunch of smart, big-hearted people to create a new kind of healthcare company one that combines compassion, health insurance, clinical care, and technology seamlessly.
We want to throw the long ball with people we love for a cause we believe in. Life is short. Join us.
The Senior Risk Adjustment Analyst supports Medicare Advantage risk adjustment
operations by analyzing internal and external data to generate insights, improve
operations and build ongoing reporting to monitor program performance and
compliance. This role also supports program management activities around risk
adjustment data management and submissions to CMS. This role requires some
domestic travel to support network partnerships and new strategic implementations
- Analyze claims and supplemental data to identify reporting gaps and/or sources of incorrect and incomplete diagnostic data
- Analysis and forecasting of risk adjusted revenue PMPM by contract, plan and member cohorts
- Perform analysis and reporting activities relating to: risk score calculation, claims/encounters data submission, chart review programs and audits, and related performance metrics
- Generate target population lists for retrospective and prospective programs.
- Calculate ROI analysis for various risk adjustment programs
- Oversee updates to department policies and procedures in regards to risk adjustment data management
- Remain current on CMS Risk Adjustment models and data collection requirements
Desired Skills and Experience:
- Bachelors degree in a quantitative discipline such as finance, economics or mathematics
- 2+ years of experience in Healthcare Analytics
- 2+ years working with Medicare Claims, MMR, MOR, MAO-002, MAO-004 and RAPs data
- Experience with healthcare claims, enrollment and pharmacy data is preferred
- Strong command of SQL; experience with Snowflake database and Periscope dashboard software preferred
Competencies and Attributes:
- Ability to independently gather, interpret and analyze data
- Ability to extract data from databases using SQL
- Ability to design and run intermediate to complex queries and reports
- Ability to identify trends, problems, and opportunities for improvement
- Intermediate skills with spreadsheets and word processing applications
- Excellent written and verbal communication skills
- Ability to work in a high paced environment independently and with cross functional groups
- Ability to manage multiple tasks
If you love running towards complex challenges and transforming them into solutions, if you want to make a potentially huge impact on many lives, and if you are looking for a disruptive startup with an inspiring and talented team, Devoted Health may be the place for you!
Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoteds Code of Conduct, our company values and the way we do business.
As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
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