Qureos Mentor

Renown Health

<div><div><div><div><div><div><div><p><b>Position Purpose</b></p><br>
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<div><div><div><div><div><div><div><div><div><div><p>The Risk Adjustment Analyst is responsible for supporting the Medicare Advantage and Commercial Risk Adjustment programs through the end-to-end processes of data management and data submissions. This will be accomplished through designing, building and automating reporting analysis and modeling by utilizing a variety of systems. The position helps to create visibility of the risk adjustment initiatives by measuring project success, KPI development and goal tracking. Along with providing analytical support for the risk adjustment initiatives, the analyst will assist in developing and implementing systems, processes and standards to ensure the risk scores appropriately reflect the disease burden of each member.</p><br>
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</div></div><p></p><div><div><div><div><p><b>Nature and Scope</b></p><br>
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<div><div><div><div><div><div><div><div><div><div><p>This position develops and coordinates the risk adjustment improvement and reporting efforts, for Hometown Health&rsquo;s Medicare and Commercial products utilizing a variety of source systems and development tools. Included within the scope of this position, the analyst will perform data extraction, analysis, report design, report build, solution deployment, and draft documentation to support the Financial and Business reporting solutions for Hometown Health. Accurate and timely project status feedback is expected to ensure compliance with established timelines.</p><br>
<p></p><p><b>KNOWLEDGE, SKILLS &amp; ABILITIES:</b></p><br>
<p></p><p>1. Perform analysis and reporting activities relating to: risk score calculation, claims/encounters data submission, chart review programs, audits, and related performance metrics.</p><br>
<p></p><p>2. Participate in the development of requirements, testing and refinement of the underlying data and systems.</p><br>
<p></p><p>3. Collaborate with other business units to deliver reports/updates on underlying data and systems as used by the Risk Adjustment team.</p><br>
<p></p><p>4. Analyze data flow and data integrity to identify areas for improvement.</p><br>
<p></p><p>5. Understand and advise on CMS risk score methodology, including risk score calculation, hierarchical condition categories (HCCs), financial risk receivable calculations, RAPS and EDS processes and key regulator deadlines for data submission, RAPS and EDS Return Files and Error Files, ICD coding, claims, and provider data.</p><br>
<p></p><p>6. Operate risk adjustment analytic vendor platforms to assist with intervention tracking, monitoring, analysis and reporting of diagnosis codes that drive risk score calculations.</p><br>
<p></p><p>7. Work cross functionally across multiple departments to design and develop financial dashboards, KPIs, and models to identify and track profit/loss and ROI trends.</p><br>
<p></p><p>8. Collaborate with Risk Adjustment Coders and Risk Adjustment Nurses to build internal projects based on diagnosis code, procedures, etc. trends for prospective and/or retrospective review.</p>
<p>9. Contribute to developing materials and presenting key updates to Senior Leadership regarding risk adjustment programs and provider and member engagement initiatives.</p><br>
<p></p><p>This position does not provide patient care</p><br>
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<div><div><div><div><div><div><p><b>Disclaimer</b></p><br>
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<div><div><div><div><div><div><p>The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.</p><br>
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</div></div><p></p><div><div><div><div><p><b>Minimum Qualifications</b><br>
Requirements - Required and/or Preferred</p><br>
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<div><div><div><div><div><div><div><div><div><div><p><b>Name</b></p><br>
</div><div><p><b>Description</b></p><br>
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<div><div><p>Education:</p><br>
</div><div><p>Must have working-level knowledge of the English language, including reading, writing, and speaking English. Bachelor&rsquo;s degree from an accredited institution required.</p>
<ul><li>Preferred concentration in Business, Finance, Economics, Computer Science or Management Information Systems.</li></ul><br>
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<div><div><p>Experience:</p><br>
</div><div><p>1. Minimum of two years in an analyst role required, preferably in the healthcare industry.</p>
<p>2. Advanced Excel skills required, that include working with large data sets, creating standardized reports, utilizing vLookups and advanced functions/ formulas; creating, using and interpreting pivot tables, filtering and formatting.</p>
<p>3. Preferred work experience with SAS and/or SQL to create queries, pull large data sets and perform data manipulations/analysis</p>
<p>4. Preferred experience with ICD codes, medical claims, Medicare Advantage and Commercial/ACA products.</p><br>
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<div><div><p>License(s):</p><br>
</div><div><p>None</p><br>
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<div><div><p>Certification(s):</p><br>
</div><div><p>None</p><br>
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<div><div><p>Computer / Typing:</p><br>
</div><div><p>Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.</p><br>
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Location: Renown Health &middot; 500618 Risk Adjustment<br>
Schedule: Full Time - Eligible for Benefits, Day, 80</div>

Risk Adjustment Analyst

<div><div><div><div><p>Renown Health is Northern Nevada's largest and only not-for-profit Academic Health System integrated with University of Nevada Reno School of Medicine, located in Reno Nevada. We are searching for an accomplished educator, clinician, and experienced <b>Cardiovascular Surgeon</b> to add to our growing CTCV Division in the Department of Surgery.
</p><p>Renown Regional is a state-of-the-art 800 bed acute care facility with comprehensive and outpatient services and 24-hour emergency care. We are the region&rsquo;s only Level II Trauma Center and Regional Transfer Center serving a catchment area of over 900,000.</p>
<p>The ideal candidate must be a Board-Certified Cardiovascular Surgeon with a minimum of 8 - 10 years&rsquo; post-fellowship clinical practice experience. The incumbent must have proven experience in performing routine and complex coronary work, valve repair and replacement, transcatheter valve procedures and complex aortic reconstruction. The surgeon will be expected to participate and help grow our ECMO program, contribute to educating students and residents, develop new service lines, and express the leadership skills to lead the division in the future if chosen to do so.
</p><p>The candidate will report up through the Division Chief, Vice Chair of Surgery, and Chair of Surgery. The addition of having Thoracic experience, benign and malignant, is considered valuable and an institutional need.</p>
<p>The candidate will be an active contributor to the growth of the Division of Cardiovascular Surgery in the Department of Surgery, but also partner with the leadership of the Cardiovascular Service line in executing on future strategic plans.</p>
<p>The Surgeon will provide on-call and elective cardiovascular surgery services for adult patients only, as well as conduct new patient consults and follow-up appointments in the Outpatient Clinic.
</p><p>Our Physicians teach Residents and Medical Students for University of Nevada, Reno School of Medicine. Ability to conduct research at our UNR Med Research facilities on the Medical School campus, as well as ongoing clinical trials in your department.</p>
<p><b>Position Highlights</b></p>
<ul><li>Monday &ndash; Friday schedule 7 am to 5 pm</li>
<li>1:4 Call rotation</li>
<li>Dedicated First Assist surgery support
</li><li>Heart and Vascular Institute located at Renown Regional Medical Center facility</li>
<li>Large Cardiac Cath Lab for rapid heart disease intervention</li>
<li>Dedicated Intensivists 24/7 over 4 Intensive Care Units &ndash; including a 38 bed CICU and brand new state of the art 34 bed Trauma/Surgical ICU</li>
<li>Dedicated Electrophysiology labs
</li><li>ECMO Program</li>
<li>Transcatheter Aortic Valve Replacement (TAVR) and MitraClip therapy</li>
<li>Around the clock Cardiac Anesthesia and Perfusion</li>
<li>Competitive Compensation &ndash; Salary guarantee + Quality Bonus</li>
</ul><ul><li>$40,000 Start to Work Bonus</li>
<li>Malpractice paid + 100% Tail Coverage</li>
<li>Full Health Benefits - Medical, Dental, Vision</li>
<li>401K</li>
<li>CME Stipend $5,000</li>
<li>No State Income Tax</li></ul><br>
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</p><p><b>About Reno/Tahoe</b></p>
<ul><li>Reno-Tahoe, a four-season destination, combines urban attractions with outdoor adventure. Reno, the &quot;Biggest Little City in the World,&quot; offers a vibrant arts scene, eclectic dining, and casino gaming.
</li><li>Renowned for its crystal-clear lake and the surrounding Sierra Nevada mountains, Lake Tahoe offers stunning scenery and outdoor recreation opportunities. Lake Tahoe is home to numerous ski resorts, making it a popular winter destination. Visitors can enjoy swimming, boating, hiking, biking, and other outdoor adventures during the summer months.
</li><li>Nestled on the Northern California border we are convenient distances to San Francisco Bay, Napa Valley, and Sacramento</li></ul><br>
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</p><p>For more information please contact Monica Mikulich, In-House Physician Recruiter at monica.mikulich@renown.org or 775-982-4534</p></div><br>
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Location: Renown Health &middot; 510701 Administration<br>
Schedule: Full Time - Eligible for Benefits, Varies, 7am - 5pm</div>

Hiring Cardiovascular Surgeon for Academic Health System in Reno/Tahoe

Join Renown Health and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Renown Health

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Risk Adjustment Analyst

Hiring Cardiovascular Surgeon for Academic Health System in Reno/Tahoe