Executive Director, Revenue Integrity Analytics and Performance Optimization
Hartford-Farmington Ave Atrium, United States
USD 131K-303K Executive-level Full Time
Tasks
- Build scalable analytics capabilities through automation and advanced methods
- Deliver executive insights on emerging risks and forecast variance
- Develop provider risk adjustment performance scorecards
- Ensure analytics align with CMS requirements
- Ensure completeness accuracy and timeliness of encounter submissions
- Establish analytical frameworks for performance drivers
- Integrate dashboards for risk adjustment provider performance and financial impact
- Lead and develop analytics leaders and subject matter experts
- Lead risk adjustment analytics strategy
- Oversee Medicare Advantage EDS and ACA EDGE submissions governance
- Own revenue integrity investment strategy
- Reconcile consistent reporting of risk scores KPIs encounter metrics and outcomes
- Support RADV EDGE and related audits with root cause analysis
Perks/Benefits
- Dental coverage
- Medical coverage
- Paid time off
- Retirement savings options
- Vision coverage
- Wellness programs
Skills/Tech-stack
Accruals | Artificial Intelligence | Automation | Budgeting | Data Engineering | Data Governance | Data Science | Data submission | Encounter Data | Encounter Data Submission | Forecasting | Healthcare Analytics | KPI Reporting | Performance Analytics | Power BI | Predictive Modeling | Provider Performance | Provider Performance Analytics | Python | Revenue integrity | Risk adjustment | Risk adjustment analytics | SAS | SQL | Tableau
Education
Roles
Regions
Countries
States
Cities
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