| Risk Adjustment Data Analysis Manager Job Description |
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| The following is a full job description for Risk Adjustment Data Analysis Manager. Here are the requirements and responsibilities for Risk Adjustment Data Analysis Manager along with statistics. If after reading this page you determine that Risk Adjustment Data Analysis Manager is not the position you are looking for, you may want to try one of these similar titles: VP of Risk Adjustment Data Analysis, Risk Adjustment Data Analysis Director, Risk Adjustment Data Analyst II, Risk Adjustment Data Analyst III, Risk Adjustment Data Analyst I, Risk Modeling Manager, Insurance Risk Manager, Risk Manager, Data Science Manager |
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| Requirements and Responsibilities For Risk Adjustment Data Analysis Manager |
| Manages an organization's risk adjustment processes to assess patient risk scores and ensure accurate reimbursement calculations. Utilizes patient health factors, their likely use of health care services, and the costs of those services to calculate payment adjustments, forecast revenue impacts, and identify coding gaps. Implements processes and standards to ensure accurate, timely, and compliant reporting to government agencies for determining risk adjustment payments. Monitors risk adjustment performance and leads and executes strategies to optimize financial performance while maintaining regulatory compliance. Coordinates audit readiness and responses to regulatory data validation reviews. Partners with coding, compliance, and clinical teams to enhance data completeness and accuracy. Requires a bachelor's degree. Typically reports to a director. Manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. |
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| Also referred to as: Health Risk Adjustment Analysis Manager, Insurance Risk Adjustment Analysis Manager, Insurance Risk Rating Analysis Manager |
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| Similar Jobs: VP of Risk Adjustment Data Analysis, Risk Adjustment Data Analysis Director, Risk Adjustment Data Analyst II, Risk Adjustment Data Analyst III, Risk Adjustment Data Analyst I, Risk Modeling Manager, Insurance Risk Manager, Risk Manager, Data Science Manager |
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| Level of Education: Risk Adjustment Data Analysis Manager Salaries with No Diploma, Risk Adjustment Data Analysis Manager Salaries with a High School Diploma or Technical Certificate, Risk Adjustment Data Analysis Manager Salaries with an Associate's Degree, Risk Adjustment Data Analysis Manager Salaries with a Bachelor's Degree, Risk Adjustment Data Analysis Manager Salaries with a Master's Degree or MBA, Risk Adjustment Data Analysis Manager Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Business Services, Edu., Gov't. & Nonprofit, Financial Services, Healthcare, Insurance | |
