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General Information

Work Location: Los Angeles, CA, USA
Onsite or Remote
Flexible Hybrid
Work Schedule
Monday-Friday, 8:00am-5:00pm, may require occasional weekend/evening hours
Posted Date
10/24/2024
Salary Range: $78500 - 163600 Annually
Employment Type
2 - Staff: Career
Duration
indefinite
Job #
20058

Primary Duties and Responsibilities

As the Medicare Advantage Risk Adjustment Performance Improvement Consultant, 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
 
UCLA Health salary range for this title code is $76,200 -$158,800/annually. Please note that the department's target pay range is $95,000-125,000/annually. 

Job Qualifications

We’re seeking a self-motivated, detail-oriented individual with:

• A Bachelor’s degree in Health Care Administration, Public Health, Population Health, Finance, Business Analytics or related field and/or equivalent experience

• Project Management (PMP) Certification, a plus

• Five or more years of experience in healthcare analytics, strategy, and/or consulting at an IPA or health plan level, required

• Three or more years of health plan experience, highly desired

• Three or more years of recent experience in risk adjustment, required

• Strong understanding of risk adjustment operations and V28 payment model and condition categories

• Project management and program management experience

• Knowledge of HIPAA regulations

• Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications, a plus

• Knowledge and understanding of ICD-10, CPT and CPT (II), and HCPCS, a plus

• 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, required