Job Information
UCLA Health Medicare Advantage Risk Adjustment Performance Improvement Consultant in Los Angeles, California
Description
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
Salary Range: $76,200 - $158,800
Qualifications
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
UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.
UCLA Health
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