Manager of Risk Adjustment Analytics
Manager of Risk Adjustment Analytics
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Job Description
Manager of Risk Adjustment Analytics
Millennium Physician Group
Fort Myers FL
Summary
The Manager of Risk Adjustment Analytics oversees all aspects of the companys health population systems healthcare analytics special projects and initiatives. This position is responsible for developing projects reports and meaningful healthcare insights for various patient populations. The Manager Risk Adjustment Analytics will use their expertise to provide recommendations on cost/utilization trends clinical transformation quality/coding and process improvement initiatives. This position will make executive level presentations and ensure the integrity of the data in the system. The Manager Risk Adjustment Analytics will maintain working relations with the companys clinical integration team care coordinator team coding/quality team and providers. This position will also work in partnership with multiple directors and senior executives throughout all areas of the organization and work closely with The Center for Medicare / Medicaid and various private insurance companies. This position will report to the Chief Analytics Officer with dotted line to the Medical Director of Value Based Programs.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
Oversees and is responsible for the following
- The validation of clinical data from multiple sources to create reports for both external and internal use
- Coordinate and maintain aggregation and integrity of data being delivered by CMS private payers and thirdparty data vendors.
- Financial performance reports on a periodic and adhoc basis for Care Coordination staff as well as physicians and executive leadership
- Reporting of monthly financial and utilization metrics
- Identifying high risk patient cohorts
- Devise creative solutions to accommodate partial data sets and custom data formats
- Ensures accuracy and timeliness of companys staff and physician reports to include regularly scheduled and adhoc reporting requests. Responsible for all followup and/or research requests regarding physician data
- Participates in project teams analyzing various new programs projects or ventures that require analysis of health population data
- Prepares reports presentations and other documents and presents these materials in meetings.
- Maintains a comprehensive working knowledge of companys electronic health record and population management system workflow
- Maintains a working knowledge of relevant Government and thirdparty health care initiatives in which the company participates. It is assumed inorder to maintain these skills that relevant seminars books periodicals and regulations be routinely reviewed.
- Fully supporting the staff in their use of the system. Maintaining manual with standard operation procedures and instructions.
- Performs other related duties as assigned or requested.
Education / Experience / Skills
- Bachelors in Business Administration Actuarial Science Finance Computer Science Information Technology Healthcare Administration or related field required
- Masters degree preferred
- Minimum of 5 years experience in Healthcare and Healthcare data analytics required; an understanding of Electronic Medical Records and population management system strongly preferred
- Knowledge of Medicare Advantage plans MSSP Accountable Care Organizations (ACO) and Commercial ACOs a plus
- Knowledge/use of analytic tools (e.g. Lightbeam Excel SQL Access SAS)
- IT systems database design or data structures
- Selfstarter with the ability to work independently and as a team
- Ability to interact with executive management
- Translating complex topics into simple terms
Benefits:
- 3 weeks PTO & 7 paid holidays
- Medical Dental Vision
- Employer Paid Basic Life & Short Term Disability coverage (goes into effect after 1 year of fulltime employment)
- 401(k) with match
- Employee Wellness
- Other Employee Discount programs like Tickets at Work and cell phone discounts
- Other benefits: Dependent Care FSA Voluntary Life Long Term Disability Critical Illness Pet Insurance and more
See Full Job Description for more details
Why Millennium
Millennium Physician Group is one of the largest comprehensive primary care practices with healthcare providers throughout Florida.
At Millennium Physician Group you will find an organization that focuses on family and building a strong network of people to care for the communities we serve. We are always searching for employees who have a strong customer service attitude fantastic teamwork skills and a willing smile ready to share.
Our promise is to provide you with the tools to do your job successfully as well as providing a team atmosphere that empowers you to seek better ways to deliver care to our patients and their families. We also promise to care for you as an individual and help you grow in your role with Millennium Physician Group.
If you are interested in joining an organization that puts an emphasis on team work and family then Millennium Physician Group is the right choice
Required Experience:
Manager
Employment Type
Full-Time
