Senior Risk Adjustment Analyst (Hybrid)
Baltimore, MD
| Employer: | CareFirst BlueCross BlueShield |
| Category: | Legal |
| Job Type: | Full Time |
Description | |
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Resp & Qualifications PURPOSE: The Senior Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of CMS risk score methodology, risk score calculation, ACA enrollment, premiums, medical and pharmacy claims, and provider data. Incumbent is responsible for performing complex analyses and problem resolution including data extraction, report design, report build and solution deployment. Additional responsibilities include establishing and maintaining business process and technical workflow documents, collaborating with multiple stakeholders at various levels throughout the Company, as well as external entities, providing coordination and support as required. ESSENTIAL FUNCTIONS:
SUPERVISORY RESPONSIBILITY: Position does not have direct reports but is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources. QUALIFICATIONS: Education Level: Bachelor's Degree OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. Experience: 5 years experience with data analysis which includes use of statistical methods, experience with programming language. Knowledge, Skills and Abilities (KSAs)
Salary Range: $61,704 - $122,551 Salary Range Disclaimer The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). Department Risk Adjustment Equal Employment Opportunity CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Where To Apply Please visit our website to apply: www.carefirst.com/careers Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. PHYSICAL DEMANDS: The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship. #LI-NH2 | |