Overview
Hybrid
$50 - $60
Full Time
Skills
Analytical Skill
Business Data
Business Requirements Gathering
Decision-making
KPI
Health Care Administration
Data Analysis
Job Details
Exp: 11+ years
Need candidates only in Michigan; No relocation accepted
Relocation candidates please don't apply
Need / EAD
Required Skills/Experience
- Business Requirements Gathering:
- They interpret complex risk adjustment programs, initiatives, data, and relevant regulations.
- They collaborate with stakeholders to gather and document business requirements for risk adjustment programs, translating them into functional specifications for technical teams.
- Reporting and Analytics:
- They develop and maintain reports to track key performance indicators (KPIs) related to risk adjustment coding and provide insights for decision-making.
- They utilize data analytics to identify potential data issues and proactively address them and assists with plans to implement effective compliance controls.
- Process Improvement:
- They analyze existing processes, identify areas for improvement, and develop strategies to enhance operational efficiency and accuracy in risk adjustment processes.
- They manage quality audits and reviews of clinical documentation and coding practices to support accurate risk adjustment.
- They assist with implementing and monitoring compliance controls, ensuring adherence to regulations and reducing the risk of non-compliance.
Education/Certifications Include:
- Bachelor's degree in healthcare administration, business, data science, or a related field with strong quantitative and analytical coursework.
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