What are the responsibilities and job description for the Medicare Advantage Risk Adjustment Performance Improvement Consultant position at University of California - Los Angeles Health?
As the Medicare Advantage Risk Adjustment Performance
Improvement Consultant, 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
UCLAHealthsalaryrangeforthistitlecodeis$76,200-$158,800/annually.Pleasenotethatthedepartment'stargetpayrangeis$95,000-125,000/annually.
We're seeking a self-motivated, detail-oriented individual with:
*A Bachelor's degree in Health Care Administration, Public Health, Population Health, Finance, Business Analytics or related field and/or equivalent experience
*Project Management (PMP) Certification, a plus
*Five or more years of experience in healthcare analytics, strategy, and/or consulting at an IPA or health plan level, required
*Three or more years of health plan experience, highly desired
*Three or more years of recent experience in risk adjustment, required
*Strong understanding of risk adjustment operations and V28 payment model and condition categories
*Project management and program management experience
*Knowledge of HIPAA regulations
*Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications, a plus
*Knowledge and understanding of ICD-10, CPT and CPT (II), and HCPCS, a plus
*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, required
University of California is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status. For the complete University of California nondiscrimination and affirmative action policy, see: UC Nondiscrimination & Affirmative Action Policy.
Salary : $76,200 - $158,800
