**Senior Risk Adjustment Business Analyst**

at Bright Health California, United States

**Our Mission is to Make Healthcare Right. Together.** Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, wecan deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

If you share our passion for changing healthcare so all people can live healthy, brighter lives apply to join our team.

**SCOPE OF ROLE**

The Bright Health Risk Adjustment Team is an integralcomponent of Brights success as it defines and ensures outstanding clinical care for our members. The Senior Risk Adjustment Business Analyst is responsible for program execution, data analytics and reporting. This role supports the execution of prospective and retrospective programs to ensure complete data capture of members diagnoses. This role works across departments, teams, and vendors to deliver a best in class processes and analytics for our Medicare business.

**ROLE RESPONSIBILITIES**

The Senior Risk Adjustment Business Analyst job description is intended to point out major responsibilities within the role, but it is not limited to these items.

* Generates monthly reporting package noting Key Performance Indicators as well as ad hoc analytics

* Authors and updates policies, procedures and program guides

* Assists with, tracks and helps implement risk adjustment related initiatives and strategies

* Authors executive level presentations and hosts monthly meetings

* Other duties and responsibilities as assigned

**SUPERVISORY RESPONSIBILITIES**

* This position will not have supervisory responsibilities.

**EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE**

* Bachelor's Degree required, ideally in a healthcare or technical related field

* Three (3) or more years experience in Medicare Advantage and risk adjustment data analytics, including the use of databases, required

* Five (5) or more years experience managing risk adjustment projects/programs

* In-depth knowledge of Medicare Advantage and related encounters or claims lifecycle

* Proven ability to communicate Medicare Advantage and related encounters or claims accuracy and reconciliation

* Extensive knowledge of risk adjustment models and strategies, preferred

* Proficient in Microsoft Office Products; Word, Excel, PowerPoint, advanced proficiency preferred

**PROFESSIONAL COMPETENCIES**

* Strong written and verbal communication skills

* Strong attention to detail

* Ability to quickly learn and adapt to meet business needs

* Experience working with Risk Adjustment vendors

* Demonstrated knowledge of risk adjustment regulations

* Ability to work independently

* Ability to build relationships with office staff, physicians, and market team

**LICENSURES AND CERTIFICATIONS**

* No licensures and/or certifications are required for this role.

**WORK ENVIRONMENT**

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. This position may also be work from home. Travel may be required.

****Were Making Healthcare Right. Together.****

We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by: **Focusing on Consumers** We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation. **Building on Alignment** We integrate and align individual incentives at all levels, from financing to optimization to delivery of care. **Powered by Technology** We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes. As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

**Voluntary Self-Identification**

For government reporting purposes, we ask candidates to respond to the below self-identification survey. Completion of the form is entirely **voluntary**. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file.

As set forth in Bright Healths Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law.

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A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

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An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

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**Voluntary Self-Identification of Disability**

We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years.

Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. D