Samaritan Health Services · 5 hours ago

Risk Adjustment Analyst (Health Plans)

Corvallis, OR

Full-time

Remote

Mid Level

3+ years exp

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Responsibilities

Responsible for the Risk Adjustment Processing System (RAPS) and Encounter Data Processing System (EDPS) data flow and related risk adjustment initiatives.

This involves oversight of risk adjustment data, analytics, operations, and vendors.

Responsible for analyzing risk data to identify opportunities to improve risk scores and the quality and effectiveness of initiatives.

Serves as the subject matter expert in risk adjustment.

Qualification

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Risk Adjustment Processing SystemEncounter Data Processing SystemICD-10 codingCPT codingFACETSMS OfficeData analysis

Required

Bachelor's Degree or equivalent experience required.

Three (3) years related experience in a health care or insurance environment required.

Experience with computer applications, including MS Office (Excel, Word, PowerPoint) required.

Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.

Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.