East Hampton, New York
Modesto, California
Stamford, Connecticut
Santa Maria, California
Minneapolis area, Minnesota
Central, New Hampshire
San Diego, California
Northern, New York
About an hour to Providence, Connecticut
Oroville, California
Lewes, Delaware
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Greater Detroit, Michigan
Livingston, Tennessee
Boston, Massachusetts
Springfield, Pennsylvania
Posted: 25-Oct-24
Location: Los Angeles, California
Salary: Open
Categories:
Internal Number: 143833487
As the Medicare Advantage Risk Adjustment Performance
Improvement Consultant, you will be responsible for:
- Serving as a Subject Matter Expert (SME) for risk adjustment with contracted IPAs
- Collaborating with IPAs on risk adjustment strategies to achieve health plan goals and KPIs
- Presenting and managing all risk adjustment programs offered by the health plan
- Act as a consultant and partner to the contracted IPAs
- Traveling to contracted IPAs within the Los Angeles County area
Salary Range: $76,200 - $158,800
We’re seeking a self-motivated, detail-oriented individual with:
• A Bachelor’s degree in Health Care Administration, Public Health, Population Health, Finance, Business Analytics or related field and/or equivalent experience
• Project Management (PMP) Certification, a plus
• Five or more years of experience in healthcare analytics, strategy, and/or consulting at an IPA or health plan level, required
• Three or more years of health plan experience, highly desired
• Three or more years of recent experience in risk adjustment, required
• Strong understanding of risk adjustment operations and V28 payment model and condition categories
• Project management and program management experience
• Knowledge of HIPAA regulations
• Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications, a plus
• Knowledge and understanding of ICD-10, CPT and CPT (II), and HCPCS, a plus
• Excellent interpersonal skills to build relationships with clinical and non-clinical personnel
• Strong analytical and creative problem-solving skills
• Proficient in Microsoft Word, Excel, PowerPoint, and Outlook
• Reliable transportation to travel to and from contracted IPAs in Los Angeles County, required
