31 Jan
Manager Risk Adjustment
Texas, Pearland , 77584 Pearland USA

Vacancy expired!

Experis A ManpowerGroup is currently engaged with one of the industrial leaders in Healthcare space which is based out of Houston TX and we are currently assisting the hiring team to identify Manager Risk Adjustments and Data Operation with strong experience in RAPS Data and SQL to join the wonderful team. It is a great opportunity to grow in both technical and leadership side.

Title: Manager Risk Adjustments and Data Operation

Location: Houston TX

Duration: Fulltime Direct Hire Opportunity.

Required Skills:
  • Bachelor's Degree in Finance, Economics, Mathematics, Healthcare Administration, or related field; OR equivalent experience
  • 7+ years of experience in data analysis, decision support, medical economics, healthcare informatics, or managed healthcare
  • 3 + years of experience supervising or managing teams and/or projects
  • 3 + years of experience working with EDI encounter (837) and response (277CA/999) files and CMS risk adjustment data files (MAO-002, MAO-004, RAPS return files)
  • Demonstrated initiative and problem-solving skills
  • Demonstrated ability to create and implement analysis/modeling that converts raw data into actionable business insights
  • Demonstrated ability to analyze and report on business units, products or service lines with minimal supervision/direction
  • Advanced proficiency in Microsoft Excel
  • Basic knowledge of Microsoft Power Point and Microsoft Word
  • 3+ years of programming experience in SQL, SAS or similar application language
  • Experience writing, debugging and documenting complex queries against relational databases
  • Experience participating in/leading system design and implementation initiatives.

Preferred Skills:
  • MBA or MHA preferred
  • Experience in the healthcare industry and familiarity with healthcare systems (e.g., enrollment/eligibility, capitation, claims payment, etc.) with a Managed Care Organization (MCO)
  • Knowledge of medical insurance products and basic underwriting concepts
  • Experience with Medicare Part C or Health Insurance Marketplaces highly desirable, particularly with CMS risk adjustment models
  • Experience in the healthcare industry with understanding of data in healthcare organizations (including claims data, ANSI 5010 837 data specifications, ICD10, Medicare Advantage, Health Insurance Marketplace, capitated payment models).
  • Experience with Statistical Software (including SAS, R, Minitab, SPSS)
  • Experience with reporting tools (including Crystal Reports and Microsoft Access)
  • Familiarity with EPIC and Clarity reporting data warehouse

Vacancy expired!


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