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Risk Adjustment BA Jobs

Adjustment Clerk Jobs
By Culligan International At Rosemont, IL, United States
SAP / ERP data management experience strongly preferred
We offer competitive compensation & benefits including:
Associates Degree, Bachelor’s preferred but not essential, or equivalent additional work experience
3-7+ years of relevant experience in Accounting / Bookkeeping / Accounts Customer Service required
Intermediate Microsoft Excel skills, with ability to create pivot tables
Own the creation of customer billing that flows through the Culligan NA Customer Service Team
Risk Adjustment Medical Coder
By CSI Companies At United States
Strong clinical knowledge related to chronic illness diagnosis, treatment and management
100% REMOTE - Work from home
Long term contract position- Benefits Offered!
What other skills/experience would be helpful to have?
Remain current on diagnosis coding guidelines and risk adjustment reimbursement reporting requirements
Active certified coder certification (CRC, CPC, CCS - P) through AHIMA or AAPC
Payments Ba Jobs
By Apex Systems At United States
Applied knowledge of Payables and Receivables treasury management products within financial services, including global ACH and Wire processing
Minimum 5 years business analysis experience, specifically in the field of business requirements development for customer facing products and services
Business analysis and requirement development experience
Experience working with cross-border and/or cross-currency (i.e., foreign exchange) transactions
Experience navigating heavily matrixed organization, including multiple business lines
Financial services or related industry experience
Program Coordinator, Risk Adjustment
By Oscar Health At United States
Support your manager by guiding decisions on an ongoing basis
3+ years of experience in Healthcare Operations
2+ years of experience with being held to and accomplishing goals
Experience / background in a fast-paced operations environment
Experience managing several critical, deliverables simultaneously
Maintain a strong grasp of our inventory and deliverables to ensure we are keeping/exceed pace against goal
Data Analyst (Ba/Da)
By LTIMindtree At Irving, TX, United States
Knowledge/experience using JIRA or similar requirement management tools.
Extensive experience eliciting requirements during real time collaborative sessions with stakeholders located in different geographic locations.
Education: Bachelor's Degree/University Degree or Equivalent work experience.
Experience performing extensive data mapping and data lineage exercises.
Experience performing in-depth data analysis and data profiling activities.
Strong interpersonal skills and techniques to solve dynamic problems, excellent teamwork skills.
Program Manager, Risk Adjustment
By Cotiviti At , Remote $100,000 - $121,000 a year
Deep knowledge of Project Management
A minimum of 3 years of successful client/program management.
Produces and manages documents related to client projects, calls, meetings, product specifications, special initiatives and follow up.
Fully accountable for ensuring that open issues are managed in a timely manner and that no key milestones are missed.
Completes all responsibilities as outlined on annual Performance Plan.
A minimum of 2 years of experience in Risk Adjustment space.
Remote Risk Adjustment Data Intake Specialist
By Cherokee Federal At , Washington, 20001
Effective time management skills to prioritize tasks, manage workloads, and meet project deadlines in a fast-paced development environment.
Evaluate and intake medical records and cover sheets for data entry within the CDAT-M system
Check submissions to ensure they meet requirements
Reports operational concerns to manager for Quality Improvement of daily processes
Demonstrates knowledge of various document types - e.g. paper records and electronic records
1-year minimum administrative work experience, including typing
Risk Adjustment Coder (Remote)
By Fidelis Care At New York, United States
Follows the Official ICD-10 guidelines for Coding and Reporting and has a complete understanding of these guidelines.
Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines.
Understands the impact of ICD-10 codes on the CMS HCC risk adjustment model.
Ability to meet productivity and accuracy standards.
Ability to defend coding decisions to both internal and external audits.
Performs other duties as assigned.
Associate, Regulatory Compliance (Risk Adjustment) - Remote
By Oscar Health At United States
Research to maintain a working knowledge of the RA regulations; interpret and apply the requirements across the enterprise.
Professional Academy of Healthcare Management (PAHM)
Work with other department leaders/managers to ensure risk adjustment (RA) compliance is monitored and practices are following industry standards.
Bachelor’s Degree or 4 years commensurate work experience.
3+ years’ experience in health plan RA compliance, regulatory affairs, government affairs, or a similar field..
Prior experience working with regulators on RA audits, compliance audits, reporting and other matters.
Risk Adjustment Program Coordinator
By Common Ground Healthcare Cooperative At Brookfield, WI, United States
Assist with communicating status of risk adjustment program to management and identify risks that require escalation
3 or more years of experience in health insurance
Strong interpersonal skills and high level of professionalism
Effective listening and critical thinking skills
Knowledge of ACA Marketplace and Risk Adjustment principles
Effective written and verbal communication skills
Risk Adjustment Auditor Jobs
By Privia Health At United States
Five-plus years of provider education experience
Monitor provider documentation after education; re-educate as needed
Prepare formalized reports from audit and education results
Provide monthly HCC education for the Audit and Education teams based on audit findings and risk
Communicate and problem-solve with senior department managers about specific HCC documentation and coding issues, and training needs
Bachelor's degree and/or relevant work experience preferred
Healthcare Ba Jobs
By GeorgiaTEK Systems Inc. At United States
Deep business-functional knowledge required, then just a rek gathering BA on a support project.
Client facing role, with excellent comm skills.
US Citizen and Green Card only No Third-party agencies Corp to Corp
Produce artifacts that may include feature definitions, user stories, flow-charts, swim-lanes, SIPOCS, and feasibility studies
Assist with data analysis in support of issue resolution or solution options on highly complex projects
· Appropriate, timely and polished communication.
Sales Pm/Ba Jobs
By Alpha Silicon At Sunnyvale, CA, United States
Experienced in waterfall, Agile, Scrum, Hybrid program management methodologies
Detailed knowledge of product development process and life cycle management
Assist current lead Program & Product Manager(s) on helping management of multiple existing work streams on large scale project(s)
Manage and upkeep of project plans, BRDs, Test Scripts and other project documents (Full project knowledge-base).
Assist with project management office aspects as determined by the Program Lead (i.e. various presentations, project status reports, RAID logs etc.)
Ensure that all project deliverables are diligently tracked and managed while meeting time sensitive deadlines
Technical Ba Jobs
By Prodware Solutions At Dallas, TX, United States
Technical BA, experience with JIRA, Confluence, API's
Technical BA - JIRA & Confluence
Dallas, TX (Onsite is good but fine with people going Hybrid 2-3 days onsite)
Prodware Solutions LLC | ORACLE Gold Partners
1661 RT 22 W, Suite # 206, Bound Brook, NJ-08805,
Sr. Manager, Strategic Initiatives (Risk Adjustment)
By Oscar Health At United States
5+ years of experience in program management
Owns the end-to-end management of cross-functional implementations/projects, including project plan creation, stakeholder engagement/management, and on-time completion
5+ years of experience in Managed Care Health Insurance and/or Managed Care Consulting
4+ years of leadership experience
4+ years of Risk Adjustment strategic experience
2+ years experience using data and metrics to drive improvements in programs
Business Analyst, Risk Adjustment
By Oscar Health At United States
Support your manager by guiding decisions and implementation on an ongoing basis
3+ years of experience in Business Strategy or Healthcare Analytics
2+ years of related work experience in healthcare
SQL (or related) data experience
Experience with ROI, sizing, and valuation analysis
2+ years of experience with implementing strategic initiatives
Medicare Risk Adjustment Coding Specialist
By American Health Plans Inc. At Nashville Metropolitan Area, United States
• Escalate appropriate coding audit issues to management as required
• Strong organizational skills; ability to time manage effectively
o 2 years’ experience in managed healthcare environment related to claims and/or coding audits
o Significant HCC experience (including knowledge of HCC mapping and hierarchy)
• Knowledgeable of coding/auditing claims for Medicare and Medicaid plans
• Extensive knowledge of ICD-9 & ICD-10 diagnostic coding and auditing
Risk Adjustment Data Analyst
By Honest Medical Group At United States
Work closely with performance management and reporting teams to provide data and reporting necessary for practice and provider scorecards.
Advanced data manipulation skills, with 3+ years of SQL experience
Advanced MS Excel skills, with 3+ years experience
Medicare and/or Risk Adjustment experience/knowledge preferred
Work closely with internal teams (Actuarial, Health Economics, and Finance) to provide data and insights necessary for financial forecasts and projections.
Perform other related responsibilities as assigned.
Program Manager - Risk Adjustment
By Molina Healthcare At United States
Required Experience/Knowledge, Skills & Abilities
3-5 years of Program and/or Project management experience.
5-7 years of Program and/or Project management experience.
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Focuses on process improvement, organizational change management, program management and other processes relative to the business.
Leads and manages team in planning and executing business programs.
Project Coordinator/ Ba Jobs
By Qual IT Resources At United States
ServiceNow usage and configuration knowledge is helpful; especially with the Vendor Management Workspace Module
Knowledgeable and experienced with coordinating a scrum team, building user stories with effective, testable acceptance criteria
Need an individual who can work independently and can build a team and manage multiple stakeholders
Needs to have strong communication skills
Experienced with Excel spreadsheets, Visio, JIRA, and Confluence
Define & Manage a project plan

Are you looking for an exciting opportunity to use your Risk Adjustment expertise to make a real difference? We are looking for a Risk Adjustment Business Analyst to join our team and help us develop and implement innovative solutions to improve our risk adjustment processes. You will have the chance to work with a dynamic team of professionals and make a lasting impact on our organization. If you are passionate about making a difference and have the skills and experience to make it happen, then this is the job for you!

Overview Risk Adjustment Business Analysts (BA) are responsible for analyzing and interpreting data related to risk adjustment programs and providing insights to support the development of risk adjustment strategies. They work closely with stakeholders to ensure that risk adjustment programs are effective and compliant with regulations. Detailed Job Description Risk Adjustment Business Analysts are responsible for analyzing and interpreting data related to risk adjustment programs. They use data to identify trends and patterns, and to develop insights that can be used to inform risk adjustment strategies. They work closely with stakeholders to ensure that risk adjustment programs are effective and compliant with regulations. They also provide guidance and support to stakeholders on risk adjustment related topics. Risk Adjustment BA Job Skills Required
• Strong analytical and problem-solving skills
• Excellent communication and interpersonal skills
• Knowledge of risk adjustment programs and regulations
• Ability to interpret and analyze data
• Proficiency in Microsoft Office Suite
• Knowledge of statistical software packages
• Ability to work independently and as part of a team
Risk Adjustment BA Job Qualifications
• Bachelor’s degree in a related field
• At least 5 years of experience in risk adjustment or related field
• Knowledge of risk adjustment programs and regulations
• Proficiency in Microsoft Office Suite
• Knowledge of statistical software packages
Risk Adjustment BA Job Knowledge
• Knowledge of risk adjustment programs and regulations
• Knowledge of data analysis and interpretation
• Knowledge of statistical software packages
• Knowledge of healthcare industry
Risk Adjustment BA Job Experience
• At least 5 years of experience in risk adjustment or related field
• Experience in data analysis and interpretation
• Experience in developing risk adjustment strategies
• Experience in working with stakeholders
Risk Adjustment BA Job Responsibilities
• Analyze and interpret data related to risk adjustment programs
• Develop insights to inform risk adjustment strategies
• Ensure compliance with regulations
• Provide guidance and support to stakeholders
• Monitor and evaluate risk adjustment programs
• Prepare reports and presentations on risk adjustment topics