Working Each Day to Make a Difference

At Community Health Plan of Washington, we're driven by our belief that everyone deserves access to quality health care.

More than 25 years ago, we made a commitment to improve the health of our communities by making quality health care accessible to all Washington state residents.

We continue that pledge today by providing affordable comprehensive coverage to more than 315,000 individuals and families throughout the state.

• We are a local not-for-profit health plan in Washington State.
• We are committed to keeping Washington families healthy.
• We connect our communities to the health resources they need.
• We provide access to high-quality care for our members.
• We connect and empower our members through technology.
• The Community Health Centers we partner with strive to support members with a comprehensive mix of medical resources in one convenient location.
• Our partnerships with Community Health Centers and our extended provider network help us improve the health care delivery system.

To learn more about how you can make a difference working at Community Health Plan of Washington, visitwww.chpw.org{rel="nofollow"}.

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Risk Adjustment Analyst II -- Hybrid, WA* *

[POSITION PURPOSE:]{.underline}

Support CHPW's risk adjustment activities, advancing the effectiveness and value of population health and risk adjustment initiatives through targeted analytics.  This role is integral in driving improved health outcomes and reducing overall healthcare costs.

[PRINCIPAL DUTIES:]{.underline}

Design, develop, and implement in depth analyses, reporting, dashboards, and trend analysis to support internal and external business customers.

Supports or leads projects/initiatives that span departments and hold accountability for providing analytic support.

Conducts routine and complex quantitative analyses and data validation using tools such as SQL, SAS, Excel, Tableau, or other analytical software.

Works with stakeholders and team to understand business questions and problems and to scope data analysis and reporting requests.

Manages the analytic component of complex departmental projects, including audits.

Maintains compliance with CMS requirements, modeling financial impacts to changes in risk adjustment data and methodologies.

Effectively tracks and monitors performance of retrospective and prospective risk adjustment programs, identifying issues and making recommendations.

Supports encounter data reporting processes for EDPS, RAPS, and the EDGE server, including tracking, reporting, and resolving rejections. Conducts gap analysis and data validation, identifying possible issues in data submission and determining financial impact.

Works directly with IS&T, Operations, and external vendors to ensure submission of accurate and complete risk adjustment data.

Provides decision support for department, including data requests for financial statement accruals, bids, and budget.

Analyze, reconcile, and evaluate/interpret complex data from various sources, maintaining data consistency and integrity. Proposes and implements innovative approaches to creating or improving automation, optimizing department processes where appropriate.

Maintain ongoing quality control of delivered reports through self-review and peer review, ensuring reports have a high degree of credibility with all users.

Complete ad hoc analyses to support internal and external customers.

Other duties as assigned. Essen