| Looking for Risk Assessment Analyst mid-level Remote in California at California, Maryland, 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 Assessment Analyst (mid-level) , please let me know if you are looking for this role and send me your updated resume also Job Description Job Role: Risk Assessment Analyst (mid-level) Duration: 6 months+ Location: Remote in California - candidates can relo to California, but must live there, ready for week 1 of work!) no acceptations MUST HAVEs Must come from Healthcare or Insurance Industry . ( Has to be on resume within the candidates 2 most current jobs ) (Hopefully candidates have a lot of Healthcare / Health Insurance companies #1 choice) Proven experience in risk assessment (4+ years in risk management) within the health insurance payor industry , with a deep understanding of the insurance value chain. General knowledge of risk control self-assessment processes. Strong knowledge of risk rating/scoring methodologies , ethical standards, and controls in health insurance payor operations . Experience with Governance Risk & Compliance (GRC) workflow platforms. Certifications: (CRM, ARM, CISA) is a plus . Job description: As a Risk Assessment Analyst, you will play a crucial role in ensuring the integrity and reliability of our health insurance payor operations. A comprehensive knowledge of the risk management life cycle (from identification through to reporting) is paramount to being successful in this role. You will be responsible for understanding the end-to-end risk assessment process, evaluating the efficacy of controls, and collaborating across all business functions to provide guidance that helps to mitigate risks effectively. Key Responsibilities: End-to-End Risk Assessment: Conduct comprehensive identification and assessment of risks within Delta Dentals legislation/regulation and regulatory/group client exam findings portfolios; from policy/contract creation to claims processing/settlement. Identify potential vulnerabilities and areas of improvement. Ethics and Controls Evaluation: Analyze and evaluate the effectiveness of controls in place to mitigate risks, ensuring compliance with industry regulations and ethical standards. Cross-Functional Collaboration: Work closely with various business functions, including actuarial, underwriting, claims, legal, compliance, grievance & appeals, credentialing, provider network, and finance, to understand their processes and assess risk exposure. Collaborate on risk mitigation strategies. Risk Mitigation Planning: Design and recommend risk mitigation plans and strategies based on assessment findings, working with relevant stakeholders to ensure proactive risk management. Data Analysis: Utilize data analysis tools and methodologies to identify trends and patterns that may indicate potential risks or areas for improvement in our health insurance payor processes. Documentation and Reporting: Maintain accurate and detailed records of risk assessment activities. Prepare and present reports to senior management and stakeholders on a regular basis. Compliance Monitoring: Monitor changes in health insurance payor regulations and industry standards to ensure ongoing compliance and recommend necessary adjustments. Qualifications: Bachelor's degree in Business, Risk Management, Finance, or a related field. Master's degree or relevant certifications (e.g., CRM, ARM, CISA) is a plus. Proven experience in risk assessment (4+ years in risk management) within the health insurance payor industry , with a deep understanding of the insurance value chain. General knowledge of risk control self-assessment processes. Strong knowledge of risk rating/scoring methodologies, ethical standards, and controls in health insurance payor operations . Excellent analytical and problem-solving skills, with the ability to use data to drive decision-making. Experience using Microsoft Office suite of products (excel, power-point, word) and Governance, Risk & Compliance (GRC) workflow platforms. Effective communication skills, including the ability to convey complex information to various stakeholders . Collaborative mindset and the ability to work across diverse business functions. Knowledge of relevant industry regulations and compliance requirements. Proficiency in using risk assessment and data analysis tools 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: Kentucky |
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| Wed Sep 27 03:09:00 UTC 2023 |