Martin's Point Health Care · 2 days ago
Senior Risk Adjustment Analyst
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Responsibilities
Examines and performs data management analyses and develops and presents a variety of performance results in addition to other pertinent communication
Transfers data into meaningful, professional, and easy to understand formats for leadership
Reviews data, develops recommendations and reviews findings with senior leadership
Analyzes and extracts data from the Enterprise Data Warehouse (EDW) and other sources to report to internal and external customers
Designs, develops, tests, documents, and maintains database queries for ad hoc reporting used in complex conceptual analyses for all departments within Risk Adjustment Operations
Develops systematic reporting processes and procedures to ensure timely delivery of daily, weekly, monthly, annual, and ad hoc reports to support key departmental and organizational initiatives
Serves as the liaison between departments including IT and Finance for all Risk Adjustment reporting needs
Troubleshoots errors and data inconsistencies and coordinates resolutions to issues as directed by self, staff, and various levels of leadership
Takes a lead role in the tracking of progress and activities of key initiatives
Plans and assists with testing processes and activities including new report or analytics methodology validation
Responsible for documenting and updating changes to workflow, training plans, policies and procedures and ensure redundancy in these knowledge areas with other analytics resources
Provides analytic mentorship and guidance to operational departments related to revenue optimization
Participates in the development of risk adjustment operational and strategic planning processes
Subject matter expert in CMS HCC Risk Adjustment modeling
May lead vendor research, software installation, configuration support, and interface development applications as needed
Maintains and is expert user of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding
Recommends tools and methodologies that can be deployed at the organizational level, to the departments and with external partner
Qualification
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Required
Bachelor’s degree in Economics, Finance, Statistics, Mathematics, Actuarial Sciences, or other quantitative discipline
Minimum of 5 years’ experience related to reporting and analysis of health care data ideally in the areas of managed care, health care delivery, code sets, and/or reimbursement
Experience in developing cost-benefit and ROI analyses
In compliance with MPHC’s Department of Defense government contract, any/all persons hired for this position will need to verify their US citizenship and complete the required employment eligibility verification upon hire.
Preferred
Master’s degree
Company
Martin's Point Health Care
Martin’s Point has nine health care centers in Maine and New Hampshire offering primary and specialty care to those with most major health.
Funding
Current Stage
Late StageRecent News
2023-11-07
2022-04-01
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