Hourly Wage for Risk Adjustment Data Analysis Manager Salary in the United States

1. What are the responsibilities of Risk Adjustment Data Analysis Manager?

Manages an organization's risk adjustment processes to assess patient risk scores and ensure accurate reimbursement calculations. Utilizes patient health factors, their likely use of health care services, and the costs of those services to calculate payment adjustments, forecast revenue impacts, and identify coding gaps. Implements processes and standards to ensure accurate, timely, and compliant reporting to government agencies for determining risk adjustment payments. Monitors risk adjustment performance and leads and executes strategies to optimize financial performance while maintaining regulatory compliance. Coordinates audit readiness and responses to regulatory data validation reviews. Partners with coding, compliance, and clinical teams to enhance data completeness and accuracy. Requires a bachelor's degree. Typically reports to a director. Manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes.