Job Summary: This position focuses on all CMS submission related operations in support of Prominence Health Plan's Medicare Advantage business. Activities include creating submission files related to chart retrievals per vendor proprietary format, perform data analysis in support of optimizing risk adjusted revenue, maintain compliance with all CMS standards related to health plan submissions, and modeling the financial impacts of changes in risk adjustment data and methodologies. This position will work with multiple internal departments, maintaining tracking documentation to ensure closure of gaps and resolution of data errors. Assist in reporting current KPIs and create new reports to appropriately track ROIs.
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