| Risk Adjustment Business Analyst Remote (Only for PST and CST Zone at Remote, Remote, USA |
| Email: [email protected] |
| From: Sushmita Soni, Sonitalent [email protected] Reply to: [email protected] Hi Hope you are doing well , We are looking for Risk Adjustment Business Analyst , please let me know if you are looking for this role and send me your updated resume also Job Description Job title: Risk Adjustment Business Analyst Location: Remote ( Only for PST and CST Zone Folks) Interview: Phone/ Skype Job Description: The Risk Adjustment Business Analyst job description is intended to point out major responsibilities within the role, but it is not limited to these items: Helps support vendor relationship and discussion as applied to contractual agreements Mentor other business analysts. Shares Care Partner (provider) related metrics with leadership teams on a cyclical basis Analyzes data to determine root cause analysis, etc. Finds, communicates, and escalates root causes and ad hoc nuances. Shares risk adjustment vendor related metrics with leadership teams on a cyclical basis. Track and help implement risk adjustment related initiatives and strategies Seeks, maintains, and builds a best a class vendor knowledgebase Relentlessly champions the importance of successful vendor economics through the lens of payer value. Authors and updates policies, procedures, and program guides. Leads annual readiness by ensuring proper setup of new products in vendor systems. Follows, reports, and adheres to all regulatory guidance. Other duties and responsibilities as assigned. Performs other duties and responsibilities as assigned. Authors executive level presentations and hosts monthly meetings Assist with data transfer and ROI calculations. EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE (Required) Bachelors degree in business or related field or relevant experience in lieu of degree. Proficient in Microsoft Office Products; Word, Excel, PowerPoint Business analysis experience preferably in a healthcare setting Preferred Skills Knowledge of Medicare Advantage and/or commercial risk adjustment models, functions, and/or strategies Two (2) or more years experience in Medicare Advantage or Commercial risk adjustment with a health plan and/or vendor Medical Record retrieval operational experience is a big plus Experience with risk adjustment initiatives such as prospective and/or retrospective programs Experience with risk adjustment vendor management/contracting/invoice reconciliation Two (2) or more years experience reporting/tracking progress of department initiatives Intermediate proficiency in SQL, SAS, and/or other data aggregation platforms Knowledge of risk adjustment encounter data lifecycle Additional Notes Strong written and verbal communication skills Strong attention to detail Ability to quickly learn and adapt to meet business needs Experience working with Risk Adjustment vendors Effective problem solver Demonstrated knowledge of risk adjustment regulations Ability to work independently Ability to build relationships with office staff, physicians, and market team Thanks & Regards Sushmita Soni Sr. Technical Recruiter| SoniTalent Corp. Desk | 859-659-1004 EXT 201 [email protected] Address - 5404 Merribrook Lane, Prospect, KY, USA Keywords: active directory information technology Kentucky |
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| Sat Sep 16 00:06:00 UTC 2023 |