Risk Adjustment Data Submissions Manager

United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Health InsuranceIndustries

Requirements

Candidates should possess a Bachelor's degree in healthcare, data analytics, or a related field, with an advanced degree being preferred. Strong communication, interpersonal, analytical, and organizational skills are essential, as is the ability to drive projects in a fast-paced environment and improve operational processes. A minimum of five years of healthcare or operational experience and strong SQL skills, preferably with Snowflake, are desired.

Responsibilities

The Risk Adjustment Data Submissions Manager will analyze and monitor data submissions for accuracy and completeness, identifying discrepancies and areas for improvement. This role involves collaborating with cross-functional teams to implement corrective actions, developing and maintaining documentation for submission processes, and educating stakeholders on encounter data submission best practices. The manager will also stay current on regulatory changes affecting risk adjustment and encounter data submissions.

Skills

Risk Adjustment

Data Submissions

Data Analysis

Operational Improvement

Process Documentation

Troubleshooting

Stakeholder Education

Regulatory Compliance

Healthcare Data

Encounter Data

Communication

Interpersonal Skills

Problem-Solving

Attention to Detail

Organizational Skills

Devoted Health

Medicare Advantage plans with personalized support

About Devoted Health

Devoted Health provides Medicare Advantage plans aimed at simplifying and making healthcare more affordable for seniors aged 65 and older. Their plans include services like provider and pharmacy searches, prescription drug coverage, and preventive care rewards. Members pay premiums for these plans, and the company may also receive government payments for managing Medicare benefits. What sets Devoted Health apart from competitors is their high level of customer service, featuring Devoted Health Guides who assist members in navigating their healthcare options and addressing common issues with traditional insurance. Additionally, they promote preventive care through the Devoted Dollars program, which rewards members for engaging in health activities. The goal of Devoted Health is to create a more compassionate and accessible healthcare experience for its members.

Waltham, MassachusettsHeadquarters

2017Year Founded

$2,194.5MTotal Funding

SERIES_ECompany Stage

HealthcareIndustries

1,001-5,000Employees

Benefits

Comprehensive health plan

401(k) retirement plan

Generous vacation and holiday time

Lyra mental health resources

Time off to vote

Risks

Increased competition from Medicare Advantage providers like Clover Health and Oscar Health.

Potential regulatory changes affecting Medicare Advantage plans by CMS.

Rising healthcare costs could impact the affordability of Devoted Health's plans.

Differentiation

Devoted Health offers personalized assistance through Devoted Health Guides for member support.

The company emphasizes preventive care with its Devoted Dollars rewards program.

Devoted Health integrates virtual and in-home care with top local providers.

Upsides

Devoted Health raised $287 million in Series E funding in 2024.

The company expanded Medicare Advantage plans to eight new states in 2023.

Devoted Health achieved a 5-star Medicare Advantage rating in Ohio in 2023.

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