Risk Adjustment Specialist (Clinical) - Remote

Overview

The Risk Adjustment Specialist will play a crucial role in transforming the health of communities by supporting the development and maintenance of Risk Adjustment related programs and reporting.

In Short

• Focus on Risk Adjustment activities.
• Conduct claims research and analysis.
• Support development and maintenance of Risk Adjustment programs.
• Work with Risk Adjustment vendors across all lines of business.
• Train providers and Health Plan staff in Risk Adjustment methodologies.
• Prepare operational workflows based on product requirements.
• Participate in meetings with various committees and providers.
• Comply with all policies and standards.
• Some travel may be required.
• Perform other duties as assigned.

Requirements

• Bachelor’s degree or equivalent experience.
• 2 years of quality improvement or clinical experience required.
• Bachelor’s degree in nursing preferred.
• Experience in the managed care industry preferred.

Benefits

• Competitive pay.
• Health insurance.
• 401K and stock purchase plans.
• Tuition reimbursement.
• Paid time off plus holidays.
• Flexible work schedule options.