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PacificSource Health Plans

Putting members first since 1933.

Senior Risk Adjustment Analyst

RiskRiskFull TimeRemoteSeniorTeam 1,001-5,000Since 1933H1B No SponsorCompany SiteLinkedIn

Location

Virginia

Posted

11 days ago

Salary

$74.6K - $126.8K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglishSQL

Job Description

Senior Risk Adjustment Analyst

PacificSource Health Plans

• Assist in the accurate and comprehensive data submission to regulatory entities • Collaborate and coordinate with internal and external partners to minimize submission and response errors • Accumulate and report out on pertinent data sets • Develop and improve processes related to risk adjustment and quality improvement • Maintain required documentation and ensure compliance to all applicable laws, guidance, and regulations • Assume lead role on specified projects • Provide mentorship to less experienced team members • Influence decision making by leadership and provide recommendations regarding potential improvements to risk adjustment processes

Job Requirements

  • Five years’ experience in data analytics or software development required
  • At least three years’ experience in Health Plan required
  • In depth risk adjustment and/or HEDIS ® experience required
  • Expertise in Microsoft Excel and SAS/SQL is required
  • Experience in leading projects and project teams required
  • Familiarity with Medicaid risk adjustment and CMS 5-Star required
  • Familiarity with Risk Adjustment Documentation, Coding practices and NCQA quality metric experience preferred
  • Bachelor's degree in Mathematics, Statistics, Health Informatics or similar research related field required
  • Advanced degrees preferred

Benefits

  • Flexible telecommute policy
  • Medical, vision, and dental insurance
  • Incentive program
  • Paid time off and holidays
  • 401(k) plan
  • Volunteer opportunities
  • Tuition reimbursement and training
  • Life insurance
  • Options such as a flexible spending account

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