In this role, you will work closely with internal and external partners to identify revenue and cost savings opportunities, support new product and business development, ensure regulatory compliance, inform contract negotiations and complete reconciliation of incentive arrangements, claims, capitation, and premium payments with other payers, vendors and/or government entities.
As aData Analyst CPCM the individual in this position will be responsible for analyzing data from CPCM inspections worldwide and developing data analysis reports for our clients using proprietary in-house analysis software.
In this role, you will be responsible for the day to day activities of the Health Plans risk adjustment error correction and discrepancy reporting programs for the Medicare Advantage and HIX lines of business.
In this role, you will integrate data from multiple sources in order to conduct studies, forecast models and to generate reports. Experience working with sociology - economic and census data is fundamental for success in this role.
In this role, you will conduct full lifecycle activities to include requirements analysis and design, develop analysis and reporting capabilities, and continuously monitor performance and quality control plans to identify improvements.