You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a dedicated Risk Adjustment Analyst for a full remote role. The successful candidate will play a pivotal role in ensuring accurate coding, appropriate reimbursement, and providing data-driven insights to enhance the organization's health plan goals. You will be part of a specialized team that collaborates with both internal and external partners to optimize risk adjustment performance across Medicare and Medi-Cal programs.

Responsibilities / Job Duties

• Develop, manage, implement, and support Risk Adjustment programs and department activities.
• Manage small to large-scale projects to advance business outcomes aligned with strategic objectives.
• Analyze and evaluate data and trends to develop and refine risk adjustment strategies and tactics.
• Act as a subject matter expert, providing guidance on complex risk adjustment activities to staff at various levels.
• Oversee the development and implementation of projects, systems, programs, policies, procedures, and workflows.
• Manage multiple projects concurrently, organize tasks, and meet goals and timelines.
• Provide leadership and facilitate meetings.

Minimum Education and Experience Qualification Requirements

Education

• Bachelor’s Degree in Finance, Business, Healthcare Administration, Mathematics, Statistics, or a related field. A Master’s degree may substitute for 2 years of the required experience; equivalent education and experience may be qualifying.

Qualifications

• 8+ years of experience in healthcare finance or analytics, with a minimum of 3 years in managing or supporting risk adjustment programs.
• Thorough knowledge of research, analysis, and reporting methods.
• Working knowledge of risk adjustment program management principles and practices.
• Familiarity with healthcare industry terms, data types, and structures, including member, claims, clinical, and provider types.

Experience

• Medi-Cal experience is preferred.

Schedule / Shift

M-F business hours

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients