Job Description
About the position
The Medicare Risk Adjustment Business Information Consultant Sr is responsible for coordinating and consolidating various impact analyses for management reporting. This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of remote work, promoting a dynamic and adaptable workplace. Responsibilities • Conduct comprehensive research and analysis to identify trends, areas for improvement, and opportunities within Medicare markets and provider networks.
• Gather and analyze data to develop insights aimed at optimizing provider performance. • Identify innovative solutions tailored to address specific provider needs and challenges. • Collaborate with cross-functional teams to develop strategies and action plans for implementing solutions. • Present research findings and proposed solutions to providers clearly and persuasively. • Build and maintain strong relationships with providers to facilitate collaboration and acceptance of solutions. • Contribute to the development and implementation of strategic initiatives aimed at improving risk adjustment outcomes.
• Monitor the effectiveness of implemented solutions and make necessary adjustments to ensure optimal outcomes. • Develop metrics and KPIs to track the success of solutions and improvements. • Prepare comprehensive reports and dashboards to communicate performance improvements to stakeholders. • Serve as a strategic partner to the business and contribute to ideas and solutions. • Influence others and work effectively to establish and develop working relationships both internally and externally with business stakeholders.
• Serve as a subject matter expert on Risk Adjustment programs and risk adjustment payment methodology. • Lead and consult with operations on ad hoc requests/special projects. Requirements • Requires a BA/BS degree in Statistics, Economics, or Business Administration and minimum of 8 years of relevant experience; or any combination of education and experience which would provide an equivalent background. Nice-to-haves • Strong analytical, organizational, presentation, and problem-solving, critical thinking skills strongly preferred.
• Healthcare business knowledge related to Risk Adjustment Payment Methodology. • Proven track record of successfully implementing provider solutions that led to measurable improvements. • Ability to interpret and analyze complex data and translate this into meaningful, actionable information for provider groups and/or market leads. • Skilled at managing multiple projects involving cross-functional teams and maintaining high standards of quality and accuracy. • Advanced skills in bolthires Office Suite, especially Excel for data handling and analysis, and PowerPoint for presentations.
• Proficiency with Business Intelligence software like Tableau, Power BI to create reports and visualizations. Benefits • Merit increases • Paid holidays • Paid Time Off • Incentive bonus programs • Medical, dental, vision benefits • Short and long term disability benefits • 401(k) + match • Stock purchase plan • Life insurance • Wellness programs • Financial education resources Apply tot his job