Professional, Risk Adjustment Analyst

At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a Professional, Risk Adjustment Analyst to join #TeamMVP. This is the opportunity for you if you have a passion for strategic engagement, data analytics, and healthcare quality improvement

• Growth opportunities to uplevel your career
• A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team
• Competitive compensation and comprehensive benefits focused on well-being
• An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work for and one of the Best Companies to Work For in New York

Qualifications you'll bring:

• Bachelor's Degree Health Administration, Business, Economics, Health Informatics, or related field.
• 1 year experience in a health insurance or business environment involving the analysis of financial or other large data sets. Masters' Degree in relevant field may be considered in lieu of this experience.
• Demonstrated problem-solving and analytical abilities along with proven ability to analyze, report and provide insight on large sets of data
• Intermediate SQL skills
• Ability to manage multiple projects and produce results within deliverable timelines and ability to transform analytical output into simple to understand findings
• Intermediate Word skills, including the ability to create moderately complex documents containing tables and graphs
• Intermediate Microsoft Excel skills, including the ability to create simple formulas, insert rows, link data, enter and sort data and produce graphs and charts
• Data visualization skills (Tableau, Power BI, etc.)
• Curiosity to foster innovation and pave the way for growth
• Humility to play as a team
• Commitment to being the difference for our customers in every interaction

Your key responsibilities:

• You will be responsible for performing analytics and reporting on Medicare, Commercial Exchange, and Medicaid/HARP member populations.
• Provide analytical support on various prospective and retrospective objectives in population health management including focus on Risk Adjustment efforts.
• Design targeting based upon disparate data sources to identify members with likely risk gaps across.
• Provide regular reporting of Risk Adjustment programs and identify opportunities and obstacles.
• Measure capture rate of Hierarchical Condition Categories (HCC)s and diagnosis codes related to Risk Adjustment programs to improve and optimize program targeting for Medicare and commercial exchange populations.
• Use Clinical Risk Group (CRG) software to target interventions for improved coding for Medicaid members. Calculates ROIs for Risk Adjustment programs.
• Maintain regulatory agency requirements for CMS and NYS related to supplemental data.
• Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.

Where you'll be:

Location: Virtual within New York, hybrid preferred

Pay Transparency
MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.

We do not request current or historical salary information from candidates.
MVP's Inclusion Statement
At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration.
MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications.

To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at hr@mvphealthcare.com.

• Headquarters Office, 625 State Street, Schenectady, New York, United States of America
• Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America