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General Information

Work Location: Los Angeles, 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: $76200 - 158800 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
 
Salary Range: $76,200 - $158,800

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



    As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.