Risk Adjustment Analyst Job at Alignment Healthcare, Orange, CA

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Job Description

Job Number 5263
Orange , California

Alignment Health was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Health team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.

POSITION SUMMARY:
The Risk Adjustment Analyst is responsible for providing and maintaining Risk Adjustment reporting, monitoring program performance to the organizations KPIs, identify and recommend areas of reporting improvement, and developing and communicating clear action plans to drive processes to both internally and externally.

GENERAL DUTIES/RESPONSIBILITIES (MAY INCLUDE BUT ARE NOT LIMITED TO):
  • Maintaining current reporting packages for internal and external clients as well as develop new reports of moderate complexity
  • Ad-Hoc analysis of various programs or projects
  • Executes standard processes / programs to accurate and timely data is provided to internal and external clients
  • Recommends and implements new or modified reporting methods and procedures to improve business processes, report content and completeness of information
  • Serves as the liaison between departments, markets and IT for all Risk Adjustment reporting needs
  • Troubleshoots all errors and data inconsistencies and coordinates resolutions to issues as directed by self, staff, regional market leadership, and corporate management
  • Attends network meetings as needed to review reports and deliverables on an as needed basis.
  • Understands how to communicate difficult and sensitive information tactfully. Proactively manages changes in project scope, identifies any potential crisis or issues and devises contingency plans to mitigate concerns
  • Responsible for documenting and updating changes to workflow, training plans, policies and procedures, as directed
  • Performs all other related duties as assigned

SUPERVISORY RESPONSIBILITIES:
N/A

MINIMUM REQUIREMENTS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Minimum Experience:
a. 2+ years of decision support, data analysis, or healthcare operations experience (if no degree)
2. Education/Licensure:
a. Bachelor's degree in Actuarial Science, Mathematics or Data Science
3. Other:
a. Possession of strong analytical/statistical skills used in evaluating and analyzing data
b. Advanced PC skills (PowerPoint, Word, Outlook)
c. Advanced Excel skills (pivot tables, reporting)
d. Intermediate SQL skills
e. Preferred:
i. 2+ years of Healthcare or risk adjustment experience
ii. Advanced SQL skills
iii. Experience using Power BI
4. Work Environment:
a. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

ESSENTIAL PHYSICAL FUNCTIONS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Alignment requires all new hires to follow local and/or state requirements regarding the COVID-19 vaccine and booster. If applicable, proof of vaccination and booster will be required as a condition of employment subject to legal exemptions. This policy, which Alignment reserves the right to modify, is part of Alignment’s ongoing efforts to ensure the safety and well-being of its staff and community and to support public health efforts.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact careers@ahcusa.com.

  • DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.

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