Risk Adjustment Analyst

  • location: Nashville, TN
  • type: Contract
  • salary: $37 - $42 per hour
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job description

Risk Adjustment Analyst

job summary:
This position is responsible for conducting healthcare business analysis of data to be submitted to CMS in support of Risk Adjustment for MAO and MMAI lines of business. This position reports to the manager of the Medicare Data Quality Operations (MDQO) Encounters team.

 
location: Nashville, Tennessee
job type: Contract
salary: $37 - 42 per hour
work hours: 9 to 5
education: Bachelors
 
responsibilities:
  • Perform daily business analysis of data to be submitted to CMS. Includes troubleshooting exceptions, exclusions and errors and coordinating results with various operational areas across the Plan.
  • Responsible for proactively monitoring data accuracy, developing repeatable error-free processes, and assisting in the development of robust action plans should issues occur.
  • Responsible to facilitate team decision making and timeliness of goals.
  • Assist in the daily technical operations of mission critical data submissions to CMS.
  • Routine coordination with the Technical Management function of CMS Data Submissions to carry out strategy and assure technical and business teams work seamlessly is core to the ongoing job function.
 
qualifications:
Bachelors degree in Computer Science or a related discipline, at least six, typically eight years of solid, diverse work experience in IT.

 
skills:
  • Knowledge of Medicare Advantage Risk Adjustment Model (HCC model).
  • Experience in working on a team following the Agile methodology.
  • Familiarity with Medicare Part C or CMS Risk Adjustment and managed care.
  • Excellent oral, written presentation and communication skills.
  • Ability to drive to results independently.
  • Analytical and creative problem solving skills.
  • Proficient in Microsoft Office Suite products.
  • Must be motived by desire for success and pursuit of excellence.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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