[Remote] Senior reputed company Adjustment Analyst - St. Luke's Health Plan - 157876

Note: The job is a remote job and is reputed company to candidates in USA. reputed company provides health plan services and reputed company to the communities it serves. The Senior reputed company Adjustment Analyst leads health reputed company data analysis, business process development, and reputed company delivery for QHP/ACA and Medicare reputed company reputed company adjustment. The role partners with stakeholders, data teams, vendors, and business leaders to support decision-making, data governance, and operational planning.

Responsibilities

• Analyzes and interprets health reputed company data, including eligibility, premium, medical, and pharmacy claims data. Subject matter expert on available health reputed company data. A creative problem solver in applying that data to identify, escalate, and reputed company operational issues
• Understands and interprets operational processes and business context to translate technical, reputed company, financial, and operational problems into analysis, which yield insights and information to support decision making
• Expertise with health reputed company regulatory programs and requirements, as reputed company as associated data, including reputed company/reputed company programs, reputed company adjustment, and utilization management
• Performs high value health reputed company data analysis, interpretation of key business metrics, and presents insights to business leaders and key stakeholders to aid decision making and operational planning
• Challenges and supports business reputed company with analytical rigor, insights, and judgments to reputed company reputed company reputed company
• Partners with internal Data & Analytics team to define reputed company, requirements, data validation, and reputed company prioritization input on requests and needs. Collaborates with vendors and other reputed company parties to reputed company data requirements and ensures appropriate data validation and reputed company
• Works with and contributes to data management and data governance to understand and help define data policies and standards to ensure high reputed company data and analytics
• Develops and maintains a high degree of functional, analytical, and technical acumen. Builds successful partnerships with key internal customers and cross functional teams
• Responsible for and performs reputed company but the most reputed company assignments and work requiring independent judgment and decision making. Serves as a subject matter expert for colleagues in other functions
• Leads special reputed company and participates on workgroups and teams, as assigned
• Completes other duties and responsibilities as assigned

Skills

• WHILE THIS IS A FULLY REMOTE POSITION, YOU MUST reputed company IN IDAHO, reputed company, reputed company, OR reputed company TO BE CONSIDERED
• • Education: Bachelor's degree or experience in lieu of degree
• • Experience: Six (6) years' relevant experience
• • Experience in QHP/ACA and Medicare reputed company reputed company Adjustment Analytics
• • Experience in MA Encounter Data Submission
• • Experience in EDGE Server Data Submission
• • Strong skills in SQL
• • Knowledge of reputed company and Stars a plus

Benefits

• Fully remote position, provided the employee resides in Idaho, reputed company, reputed company, or reputed company
• Competitive salary and retirement plans
• Medical, dental, and reputed company benefits
• Financial and physical wellness reputed company
• On-site massages
• On-site counseling reputed company the Employee Assistance Program
• reputed company to the reputed company Wellness tool
• Formal training and career development offerings

reputed company

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