Risk Adjustment Analyst

Risk Adjustment Analyst

Headquarters Office, 625 State Street, Schenectady, New York, United States of America

• Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America
• Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America Req #2173

Wednesday, September 4, 2024

At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement.

To achieve this, we're looking for a Professional, Risk Adjustment Analyst to join #TeamMVP. This is the opportunity for you if you have a passion for data analysis and interpretation, regulatory compliance, and healthcare insurance.

What's in it for you :

• Growth opportunities to uplevel your career
• A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team
• Competitive compensation and comprehensive benefits focused on well-being
• An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work for and one of the Best Companies to Work For in New York

Qualifications you'll bring :

Bachelor's Degree 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.

Masters' Degree in relevant field may be considered in lieu of this experience

• Demonstrated problem-solving, analytical abilities, and ability to work independently w ith strong attention to detail, and written and verbal communication skills
• Intermediate SQL skills, Microsoft Words skills, Microsoft Excel skills, and Data visualization skills ( (Tableau, Power BI, etc.)
• Ability to manage multiple projects and produce results within deliverable timelines, a bility to transform analytical output into simple to understand findings along with proven ability to analyze, report and provide insight on large sets of data
• Curiosity to foster innovation and pave the way for growth
• Humility to play as a team
• Commitment to being the difference for our customers in every interaction

Your key responsibilities :

• Performing analytics and reporting on Medicare, Commercial Exchange, and Medicaid / HARP member populations
• Analytical support on various prospective and retrospective objectives in population health management including focus on Risk Adjustment efforts
• Design targeting based upon disparate data sources to identify members with likely risk gaps across
• Provide regular reporting of Risk Adjustment programs and identify opportunities and obstacles
• Measure capture rate of Hierarchical Condition Categories (HCC)s and diagnosis codes related to Risk Adjustment programs to improve and optimize program targeting for Medicare and commercial exchange populations
• Use Clinical Risk Group (CRG) software to target interventions for improved coding for Medicaid members
• Calculates ROIs for Risk Adjustment programs. Maintain regulatory agency requirements for CMS and NYS related to supplemental data
• Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.

Where you'll be :

Location : Remote within New York State

Pay Transparency

At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting.

Specific employment offers and associated compensation will be made individually based on several factors, including but not limited to geographic location;

relevant experience, education, and training; and the nature of and demand for the role.

Affirmative Action

MVP is an Affirmative Action / Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.

g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at [email protected] .

Other details

• Job Family Finance / Accounting
• Pay Type Salary
• Min Hiring Rate $69,383.00
• Max Hiring Rate $105,000.00

Apply Now

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Headquarters Office, 625 State Street, Schenectady, New York, United States of America

Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America

Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America

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