Description
UCLA HEALTH
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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
UCLA Health salary range for this title code is $78,500-$163,600/annually. Please note that the department’s target pay range is $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