Manager of Risk Adjustment Analytics

New York, NY, US • Posted 3 days ago • Updated 3 days ago
Full Time
No Travel Required
On-site
$140,000 - $160,000/yr
Fitment

Dice Job Match Score™

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Job Details

Skills

  • Health Care
  • SQL
  • Medicare
  • CMS
  • 837 files
  • Risk Adjustment
  • Medicare Advantage
  • HCC modeling

Summary

Full Time Job Opening: Manager of Risk Adjustment Analytics / New York City Metropolitan Area
 
JOB OPENING:
Position: Manager of Risk Adjustment Analytics
Location: New York, New York 10271 - Onsite
Work Schedule: Monday - Friday, 9:00am - 5:00pm

Key skills and experience we are looking for include:

  • Deep understanding of Risk Adjustment and Medicare Advantage programs.
  • Strong analytical and reporting capabilities, including recapture rate and RAF trend analysis.
  • Advanced SQL skills and experience working with large healthcare datasets.
  • Experience creating and managing 837 encounter files.
  • Knowledge of claims data, encounter submissions, and CMS reporting processes.
  • Experience managing retrospective chart review outcomes, including adds and deletes submitted to CMS.
  • Ability to transform complex data into meaningful, actionable reporting for leadership.
  • Strong communication skills and the ability to connect analytics to broader business and operational goals.

 

I am looking for a manager who can help revamp our risk adjustment reporting and develop meaningful analytics around these areas. The creation of 837 files is currently a major initiative for our team, and the role will also involve linking claims, managing adds and deletes submitted back to CMS following retrospective chart reviews, and supporting other key risk adjustment initiatives.
Required qualifications:
  • 6-10 years in risk adjustment and/or healthcare analytics
  • Deep expertise in Medicare Advantage risk adjustment, HCC modeling, and CMS methodologies
  • Strong knowledge of value-based care contracts, policy, operations, and financial methods
  • Proficiency with SAS, SQL, and data mining tools
  • Bachelor's degree required (Master's preferred)
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: 91175902
  • Position Id: 9077495
  • Posted 3 days ago
Contact the job poster
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Narayana Rao

Recruiter @ MetaRPO
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