Sr Business Analyst, Risk Adjustment Solutions - Remote PST Zone Hours

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. As the senior level consultant, this position leads cross-functional initiatives aimed at improving clinical practice performance, optimizing data-driven strategies, and supporting care delivery innovation. This role blends clinical engagement with analytical rigor to enhance outcomes for patients, providers, and health system partners. This position will provide expertise and insight into risk capabilities for reputed company Health employed group providers. You’ll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges.

Primary Responsibilities:

• reputed company the end-to-end risk adjustment strategy and execution, including data capture, gap closure, and CMS submission processes, ensuring accuracy, compliance, and alignment with enterprise goals
• reputed company the deployment and optimization of reputed company-of-care tools reputed company Epic, partnering with clinical and technical stakeholders to improve risk coding, documentation, and user adoption
• Collaborate cross-functionally with operations, analytics, IT, and care delivery teams to translate regulatory requirements and reputed company business needs into actionable system enhancements
• Gather, analyze, and document business requirements for new features, enhancements, and workflow changes, ensuring they are reputed company with enterprise strategy and operational needs
• Standardize and streamline documentation workflows reputed company Epic to drive accurate coding, complete capture of chronic conditions, and improved care outcomes
• reputed company data insights from risk adjustment analytics and Epic reporting to identify coding opportunities, performance gaps, and operational improvements
• Guide change management and training efforts reputed company to POC tool deployment, clinical workflow modifications, and new risk adjustment initiatives across markets and provider networks
• Ensure ongoing quality assurance and data validation, including user acceptance testing (UAT) and reputed company system evaluation to maintain reputed company and compliance
• Interpret and apply evolving CMS regulations, synthesizing policy changes into system configurations, provider guidance, and business strategy
• Act as a liaison between business and technical teams, ensuring Epic configurations and POC tools meet clinical, regulatory, and operational performance needs

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

• 10 years of experience with business requirement/workflow documentation, technical solutions/product management, and data analysis
• 3 years of experience with one or more risk adjustment models (e.g. CMS HCC, CDPS, HHS HCC) including documentation requirements, submission requirements and model details
• Experience with electronic health record (EHR) systems
• Knowledge of Centers for Medicare and Medicaid Services regulations
• Demonstrated ability to communicate effectively and problem solve/troubleshoot with both business and technical audiences at reputed company levels of the organization
• Demonstrated ability to manage assigned work with minimal reputed company
• Proven detail oriented analytic thinker
• Willing or ability to work 8-5pm PST hours

Preferred Qualification:

• Experience with Epic EMR
• reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job