Strategic Staffing Solutions
Risk Adjustment Business Analyst
Strategic Staffing Solutions, Grand Rapids, Michigan, us, 49528
Job Description
STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!
Strategic Staffing Solutions is currently looking for a Business Analyst for a contract opportunity with one of our largest clients located in Grand Rapids, MI!
Title:
Risk Adjustment Business Analyst Location:
Grand Rapids, MI (hybrid/onsite 1 day per week) Duration:
10+ Months Role Type:
W2 Contract Engagement
Engagement Description
This role requires a highly skilled
Risk Adjustment Business Analyst
who can bridge regulatory requirements with operational execution across Medicare Advantage and other risk-bearing programs. The analyst will help ensure compliance with CMS guidelines, minimize operational risk, and contribute to the overall success of Risk Adjustment activities by the plan.
Top Skills/Experience
Research, interpret and understand CMS regulations and applicable laws pertaining to risk adjustment Collaborate with stakeholders to gather and document business requirements for risk adjustment programs, translating them into functional specifications for business teams. Develop and implement risk assessment and monitoring review processes to mitigate and/or remediate risk within the risk adjustment space Track and manage corrective action plans to address identified compliance risks and deficiencies Analyze existing controls and processes against guidance to enhance and strengthen those processes and controls in alignment with current guidance and best practices. Support the documentation, implementation and tracking of controls and systems which create enhanced efficiency and effectiveness. Additional Required Skills/Experience
Data Analysis: Ability to analyze large datasets to identify trends, patterns, and anomalies related to risk adjustment and compliance. Using data analysis tools and software. Interpreting data to understand risk adjustment and compliance issues. Experience with BI tools and reporting platforms to create dashboards and reports for monitoring risk adjustment performance and compliance. Proficiency in MS Office applications Risk Adjustment Program Knowledge: Understanding of relevant risk adjustment programs, such as Medicare Advantage, and their specific compliance requirements. Regulatory Compliance: Knowledge of healthcare regulations and laws, including HIPAA, and how they apply to risk adjustment data and processes. Ability to analyze existing business processes, identify inefficiencies, and recommend improvements to enhance compliance and performance. Preferred Skills/Experience
Prior roles in a compliance and/or regulatory department Education/Certifications
Bachelor's degree in healthcare administration, business, or a related field with strong quantitative and analytical coursework Compliance related certification, e.g., CHC, CCP would be a plus, not required
*Beware of scams. S3 never asks for money during its onboarding process
STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!
Strategic Staffing Solutions is currently looking for a Business Analyst for a contract opportunity with one of our largest clients located in Grand Rapids, MI!
Title:
Risk Adjustment Business Analyst Location:
Grand Rapids, MI (hybrid/onsite 1 day per week) Duration:
10+ Months Role Type:
W2 Contract Engagement
Engagement Description
This role requires a highly skilled
Risk Adjustment Business Analyst
who can bridge regulatory requirements with operational execution across Medicare Advantage and other risk-bearing programs. The analyst will help ensure compliance with CMS guidelines, minimize operational risk, and contribute to the overall success of Risk Adjustment activities by the plan.
Top Skills/Experience
Research, interpret and understand CMS regulations and applicable laws pertaining to risk adjustment Collaborate with stakeholders to gather and document business requirements for risk adjustment programs, translating them into functional specifications for business teams. Develop and implement risk assessment and monitoring review processes to mitigate and/or remediate risk within the risk adjustment space Track and manage corrective action plans to address identified compliance risks and deficiencies Analyze existing controls and processes against guidance to enhance and strengthen those processes and controls in alignment with current guidance and best practices. Support the documentation, implementation and tracking of controls and systems which create enhanced efficiency and effectiveness. Additional Required Skills/Experience
Data Analysis: Ability to analyze large datasets to identify trends, patterns, and anomalies related to risk adjustment and compliance. Using data analysis tools and software. Interpreting data to understand risk adjustment and compliance issues. Experience with BI tools and reporting platforms to create dashboards and reports for monitoring risk adjustment performance and compliance. Proficiency in MS Office applications Risk Adjustment Program Knowledge: Understanding of relevant risk adjustment programs, such as Medicare Advantage, and their specific compliance requirements. Regulatory Compliance: Knowledge of healthcare regulations and laws, including HIPAA, and how they apply to risk adjustment data and processes. Ability to analyze existing business processes, identify inefficiencies, and recommend improvements to enhance compliance and performance. Preferred Skills/Experience
Prior roles in a compliance and/or regulatory department Education/Certifications
Bachelor's degree in healthcare administration, business, or a related field with strong quantitative and analytical coursework Compliance related certification, e.g., CHC, CCP would be a plus, not required
*Beware of scams. S3 never asks for money during its onboarding process