University of California - Los Angeles Health
Medicare Advantage Risk Adjustment Performance Improvement Specialist
University of California - Los Angeles Health, Los Angeles, California, United States, 90079
Description
As the Medicare Advantage Risk Adjustment Performance Improvement Specialist, you will be responsible for:
Serving as a Subject Matter Expert (SME) for risk adjustment with contracted IPAs
Collaborating with IPAs on risk adjustment strategies to achieve health plan goals and KPIs
Presenting and managing all risk adjustment programs offered by the health plan
Act as a consultant and partner to the contracted IPAs
Traveling to contracted IPAs within the Los Angeles County area
UCLAHealthsalaryrangeforthistitlecodeis$78,500-$163,600/annually.Pleasenotethatthedepartment'stargetpayrangeis$95,000-125,000/annually.
Qualifications We're seeking a self‑motivated, detail‑oriented individual with:
Required:
A Bachelor's degree in Health Care Administration, Public Health, Population Health, Finance, Business Analytics or related field and/or equivalent experience
Five or more years of experience in healthcare analytics, strategy, and/or consulting at an IPA or health plan level
Three or more years of recent experience in risk adjustment
Strong understanding of risk adjustment operations and V28 payment model and condition categories
Knowledge of HIPAA regulations
Project management and program management experience
Excellent interpersonal skills to build relationships with clinical and non‑clinical personnel
Strong analytical and creative problem‑solving skills
Proficient in Microsoft Word, Excel, PowerPoint, and Outlook
Reliable transportation to travel to and from contracted IPAs in Los Angeles County
Preferred
Project Management (PMP) Certification, a plus
Three or more years of health plan experience, highly desired
Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications
Knowledge and understanding of ICD-10, CPT and CPT (II), and HCPCS
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Serving as a Subject Matter Expert (SME) for risk adjustment with contracted IPAs
Collaborating with IPAs on risk adjustment strategies to achieve health plan goals and KPIs
Presenting and managing all risk adjustment programs offered by the health plan
Act as a consultant and partner to the contracted IPAs
Traveling to contracted IPAs within the Los Angeles County area
UCLAHealthsalaryrangeforthistitlecodeis$78,500-$163,600/annually.Pleasenotethatthedepartment'stargetpayrangeis$95,000-125,000/annually.
Qualifications We're seeking a self‑motivated, detail‑oriented individual with:
Required:
A Bachelor's degree in Health Care Administration, Public Health, Population Health, Finance, Business Analytics or related field and/or equivalent experience
Five or more years of experience in healthcare analytics, strategy, and/or consulting at an IPA or health plan level
Three or more years of recent experience in risk adjustment
Strong understanding of risk adjustment operations and V28 payment model and condition categories
Knowledge of HIPAA regulations
Project management and program management experience
Excellent interpersonal skills to build relationships with clinical and non‑clinical personnel
Strong analytical and creative problem‑solving skills
Proficient in Microsoft Word, Excel, PowerPoint, and Outlook
Reliable transportation to travel to and from contracted IPAs in Los Angeles County
Preferred
Project Management (PMP) Certification, a plus
Three or more years of health plan experience, highly desired
Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications
Knowledge and understanding of ICD-10, CPT and CPT (II), and HCPCS
#J-18808-Ljbffr