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Non Union Hcc Risk Adjustment Jobs in Florida (NOW HIRING)

Centrum Health

Risk Adjustment Analyst

Doral, FL

Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP Quality Reporting PROFESSIONAL COMPETENCIES * Expertise in analytics, statistics, data visualization, or ...

Centrum Health

Risk Adjustment Analyst

Doral, FL · On-site

Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP Quality Reporting PROFESSIONAL COMPETENCIES * Expertise in analytics, statistics, data visualization, or ...

PedIM Healthcare

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

  • Medical

  • Life

  • Retirement

  • PTO

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

  • Medical

  • Life

  • Retirement

  • PTO

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

  • Medical

  • Life

  • Retirement

  • PTO

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

PedIM Healthcare

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

  • Medical

  • Life

  • Retirement

  • PTO

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

BHC ISC

PBO Risk Adjustment Coding

Fort Lauderdale, FL · On-site

... Risk HRA/HCC Assessment forms Medicare Advantage plans suspect HCC condition forms prior to ... High School or Equivalent Experience: 2-5 years of risk adjustment coding E/M procedures and ...

Msmc

Certified Risk Adjustment Coder

Hialeah, FL · On-site

$20.50 - $27.75/hr

  • Medical

  • Life

  • Retirement

  • PTO

Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports * Queries and ... Demonstrates understanding of risk adjustment payment models * Uses clinical reasoning and critical ...

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All JobsNon Union Hcc Risk Adjustment JobsNon Union Hcc Risk Adjustment Jobs in Florida

Non Union Hcc Risk Adjustment information

What is the difference between Non Union Hcc Risk Adjustment vs Non Union Medical Coder?

AspectNon Union Hcc Risk AdjustmentNon Union Medical Coder
CredentialsCertifications in risk adjustment, coding, or healthcare analyticsMedical coding certifications (CPC, CCS, etc.)
Work EnvironmentInsurance companies, healthcare analytics firms, or risk adjustment departmentsHospitals, clinics, or medical billing companies
Industry UsageFocuses on risk scoring for insurance reimbursement and healthcare planningFocuses on translating medical records into codes for billing and documentation

Non Union Hcc Risk Adjustment specialists primarily analyze health data to optimize risk scores for insurance purposes, while Non Union Medical Coders focus on accurately coding medical records for billing. Both roles require healthcare certifications but differ in their core functions and work settings.

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The most popular types of Hcc Risk Adjustment jobs in Florida are:

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Non Union Hcc Risk Adjustment jobs near you

Risk Adjustment Analyst

Centrum Health

Doral, FL

Full-time

Re-posted 15 days ago

Job description

SCOPE OF ROLE 

The Risk Adjustment and Analytics Team is working to push boundaries to redefine Risk Adjustment and Quality Analytics in a Value-Based Care Setting. The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk Adjustment and Quality Data and Dashboards for our entire NeueHealth Portfolio: ACA, Medicare, ACO REACH, MSSP, and Medicaid. The Risk Adjustment and Quality Analyst will be responsible for working both independently and collaboratively between multiple departments such as Analytics, Risk Adjustment and Quality, Medical Economics, & Clinical Operations.

This is an onsite position in Doral, FL.

ROLE RESPONSIBILITIES

  • Proactively collaborate and interact with business stakeholders across the organization to understand analytics needs, develop plans to address those needs, and deliver analytics to meet those needs.
  • Using SQL code, mine data on medical spend, clinical data and population health data and derive meaningful insights to improve operations such as trends, correlations and patterns.
  • Own the data. You are responsible for accurate presentation of your data elements, so ensuring data integrity is paramount.
  • Thoroughly analyze data, quickly identify relevant information, and transform it into a meaningful output.  Conduct thoughtful presentations, online or in person, to stakeholders with actionable findings for improvement.
  • Provide concise data reports and clear data visualizations for executive level reporting through Power BI, Excel and other tools used by the organization.
  • Create data processes that are consistent, repeatable, and scalable.
  • Conduct Quarterly Reconciliations to identify dropped HCCs and prepare supplemental data submission files according to payor partner specifications.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • Bachelor's degree is required.
  • Comprehensive understanding of risk adjustment and quality programs across all government-regulated lines of business, including Marketplace, Medicaid, and Medicare programs.
  • Five (5) or more years of hands-on SQL code development is required, including expertise with programming languages like Scala or Python.
  • Three (3) or more years of experience in healthcare field dealing with claims/utilization as it pertains to Risk Adjustment and Quality.
  • Three (3) or more years of analytics experience (Required)
  • Two (2) or more years of Power BI experience (Required)
  • Experience with Databricks (Preferred)
  • Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models
  • Familiarity with HEDIS and MSSP Quality Reporting

PROFESSIONAL COMPETENCIES

  • Expertise in analytics, statistics, data visualization, or programming
  • Dedicates exacting attention to detail and data quality
  • Eager learner, collaborative partner, easy communicator, and careful analyst
  • Passion for empirical research and answering hard questions with data

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