Identifies risk-based/alternative reimbursement program initiatives. Implements program design plans requiring assessment, research and analysis. Coordinates implementation of risk-based program plans and evaluates outcomes.
Job Responsibility
Assists in preparing program assessment, analysis, and strategy recommendations; interfaces with management to collect statistical, utilization, financial, quality and risk performance data for analysis.
Evaluates analyses and identifies high risk populations and makes strategic program recommendations; conducts research; identifies industry standards and new innovative practices for analysis.
Assists in preparing operational analysis, flow charts, presentations and reports, as required by program specifications; presents analysis and recommendations to management; obtains feedback and collaborates with management to develop program improvement plans.
Implements risk-based programs; partners with the leadership to implement program initiatives; monitors program plan performance and prepares status reports.
Collects data for review and analysis.
Prepares analysis and reports for management.
Prepares additional recommendations and adjustments to plan, as needed.
Operates with direct guidance and work assignments are generally straightforward and of moderate complexity.
Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
Job Qualification
Bachelor's Degree required, or equivalent combination of education and related experience.
0-1 years of relevant experience, required.
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