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Support Medicare Advantage Stars and Risk Adjustment application activities for companys Medicare Advantage markets through Agile IT project and product management processes. Perform data submission work and reviews, including Centers for Medicare and Medicaid Services (CMS) submission data through EDPS (Electronic Data Processing System) and RAPS (Risk Adjustment Processing System). Support risk adjustment audit and compliance activities by applying compliance and CMS requirements to internal risk adjustment applications. Perform quality assurance reviews, analyze CMS submission files, and assist IT partners with deployment and regression testing. Use healthcare analytics to facilitate internal application support. Collaborate with coding and auditing business partners to pull data and reporting related to annual medical reviews, medical chart retrieval, and government CMS Medicare Advantage audits. Conduct stakeholder interviews and capture business requirements for Agile development team. Manage technology implementations and vendor relationships. Partial work from home benefit available.
Three (3) years of experience in information systems. Must have experience with healthcare analytics, Jira, SQL, Tableau, and working in an Agile environment.
A bachelors degree or foreign equivalent in Management Information Systems, Computer Management, Computers, Engineering or a related field

Please copy and paste your resume in the email body do not send attachments, we cannot open them and email them at candidates at (link removed) with reference #0251172 in the subject line.
Thank you.