Sr. Business Analyst - Risk Adjustment Loc: Huntington Beach, CA
100,000 - 200,000
Job Description:
Responsibilities
- Develop an in-depth knowledge of various risk adjustment and quality programs ( CMS-HCC risk model, CMS HEDIS / STAR Quality measures, Health Exchange Risk Model, Medicaid Risk Model )
- Build and maintain financial models to support the business
- Produce clear, well-formatted reports in a concise, yet meaningful manner for various audiences
- Develop and maintain operational and financial reports to clearly communicate actual results and variances to plan, forecast and budget to department and business leaders
- Knowledge of medical terminology and coding ( ICD-10 diagnostic coding )
- Validate all reports for accuracy and reasonableness
- Coordinate activity / data exchange with 3rd party vendors to support business activities
- Assist in developing business level metrics to enable business leaders to make informed decisions around risk adjustment opportunities and operational activities
- Conduct cost-benefit analysis, calculate cost impact, and summarize findings
- Ability to independently research, interpret and process data into actionable reports and/or processes
- Automate and streamline reporting and business processes
- Prepare ad hoc financial analyses and other duties as necessary to support the team
Qualifications
Required Qualifications:
- Bachelor??s Degree in Accounting, Finance or related field
- 3+ years relevant risk adjustment, finance and/or accounting experience
- Strong analytical and communication skills with the ability to problem solve
- Excellent Microsoft Excel, PowerPoint, Access / database and financial modeling skills
- Proficient knowledge of SQL
- Strong organizational and planning skills
- Must meet established deadlines and produce accurate work produc
Required Qualifications
- Bachelor??s Degree in Accounting, Finance or related field
- 3+ years relevant risk adjustment, finance and/or accounting experience
- Strong analytical and communication skills with the ability to problem solve
- Excellent Microsoft Excel, PowerPoint, Access / database and financial modeling skills
- Proficient knowledge of SQL
- Strong organizational and planning skills
- Must meet established deadlines and produce accurate work product
Preferred Qualifications
- CPA or MBA
- Healthcare experience
- Self-driven in nature with minimal supervision on day to day activities
- Work independently, take initiative, and meet deadlines
- Presentation and reporting experience
- Develop an in-depth knowledge of various risk adjustment and quality programs ( CMS-HCC risk model, CMS HEDIS / STAR Quality measures, Health Exchange Risk Model, Medicaid Risk Model )
- Build and maintain financial models to support the business
- Produce clear, well-formatted reports in a concise, yet meaningful manner for various audiences
- Develop and maintain operational and financial reports to clearly communicate actual results and variances to plan, forecast and budget to department and business leaders
- Knowledge of medical terminology and coding ( ICD-10 diagnostic coding )
- Validate all reports for accuracy and reasonableness
- Coordinate activity / data exchange with 3rd party vendors to support business activities
- Assist in developing business level metrics to enable business leaders to make informed decisions around risk adjustment opportunities and operational activities
- Conduct cost-benefit analysis, calculate cost impact, and summarize findings
- Ability to independently research, interpret and process data into actionable reports and/or processes
- Automate and streamline reporting and business processes
- Prepare ad hoc financial analyses and other duties as necessary to support the team