<p>011260 CCA-Revenue Cycle Management</p> <p>Position Summary:</p> <p>The Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs, initiatives, and data through the employment of business requirements gathering, project management techniques, business systems analysis, and reporting using a variety of reporting platforms, systems, sources, and data formats. They will collaborate with other business units on the program and project structures, data gathering and transformation methodology, and will play an essential role in driving Risk Adjustment (RA) Program performance.</p> <p>Supervision Exercised:</p> <ul> <li>No, this position does not have direct reports. </li></ul> <p>Essential Duties & Responsibilities:</p> <ul> <li>Identifying opportunities for improvement that drives risk adjustment initiatives and program. </li><li>Operational Business Partner supporting vendor management, internal business partners and clinical delivery partners, ensuring all identified gaps are addressed timely </li><li>Support Provider Network Management </li><li>Associate will be responsible for systems and processes for all essential Health Plan risk adjustment program activities including identifying gaps in coding and documentation </li><li>Prospective and retrospective reviews, analytics and reporting </li><li>Ensuring RA program activities are being executed as planned </li><li>Manage direct reports for Program Initiatives </li></ul> <p>Working Conditions:</p> <ul> <li>Standard office conditions. </li></ul> <p>Required Education (must have):</p> <ul> <li>Bachelor's degree or an equivalent combination of education and highly relevant work experience </li></ul> <p>Desired Experience (nice to have):</p> <ul> <li>Two plus years' experience in healthcare industry or related field which includes direct or indirect work with public health certificate/coursework, claims management systems, EMR platforms, healthcare regulations, Risk Adjustment MA/HHS, project management, data visualization, or other clinical related background </li></ul> <p>Required Knowledge, Skills & Abilities (must have):</p> <ul> <li>High-level of knowledge of Microsoft software suite including Word, PowerPoint, Visio and intermediate to Advanced skill level with Microsoft Excel. </li><li>Understanding of medical terminology and familiarity with medical records. </li><li>Ability to interact and communicate effectively with healthcare providers. </li><li>Strong communication and meeting facilitation skills. </li><li>Strong written skills (process documentation, software documentation, etc.). </li><li>Ability to effectively manage time, prioritize work, multi-task across many assignments without reminders or prompting from management. </li><li>Working knowledge of the provider-based healthcare industry and Risk Adjustment preferred. </li></ul> <p>Required Language (must have):</p> <ul> <li>English </li></ul>