The Risk Adjustment Analyst serves as a strategic partner to the business segments within the St. Luke’s Health Plan. In alignment with identified strategies and tactics, leads the development of business processes and delivery of insights and health insurance data analysis, while working with cross-functional stakeholders.
This role is specifically for a Risk Adjustment Analyst to bring their knowledge, technical skills, and experience in risk adjustment for QHP/ACA and Medicare Advantage to the St. Luke’s Health Plan.
What You Can Expect:
* Analyzes and interprets health insurance data, including eligibility, premium, medical, and pharmacy claims data. Subject matter expert on available health insurance data. A creative problem solver in applying that data to identify, escalate, and resolve operational issues.
* Understands and interprets operational processes and business context to translate technical, clinical, financial, and operational problems into analysis, which ...