Medicare Advantage Risk Adjustment Performance Improvement Specialist at UCLA Health
United States
$78.5k - $163.6k
<h3> General Information </h3> <p aria-hidden="true"> Press space or enter keys to toggle section visibility </p> <strong>Work Location: Los Angeles, CA, USA</strong> Onsite or Remote Flexible Hybrid Work Schedule Monday-Friday, 8:00am-5:00pm, may require occasional weekend/evening hours Posted Date 01/08/2026 <strong>Salary Range</strong>: $78500 - 163600 Annually Employment Type 2 - Staff: Career Duration indefinite Job # 28410 <h3> Primary Duties and Responsibilities </h3> <p aria-hidden="true"> Press space or enter keys to toggle section visibility </p> <p>As the Medicare Advantage Risk Adjustment Performance Improvement Specialist, you will be responsible for:<br/></p><ul><li>Serving as a Subject Matter Expert (SME) for risk adjustment with contracted IPAs</li><li>Collaborating with IPAs on risk adjustment strategies to achieve health plan goals and KPIs</li><li>Presenting and managing all risk adjustment programs offered by the health plan </li><li>Act as a consultant and partner to the contracted IPAs</li><li><span>Traveling to contracted IPAs within the Los Angeles County area</span><br/></li></ul><span> </span> <span><br/></span>UCLA Health salary range for this title code is $78,500-$163,600/annually. Please note that the department's target pay range is $95,000-125,000/annually. <br/> <h3> Job Qualifications </h3> <p aria-hidden="true"> Press space or enter keys to toggle section visibility </p> <p>We’re seeking a self-motivated, detail-oriented individual with: </p><p>Required: </p><ul><li>A Bachelor’s degree in Health Care Administration, Public Health, Population Health, Finance, Business Analytics or related field and/or equivalent experience</li><li>Five or more years of experience in healthcare analytics, strategy, and/or consulting at an IPA or health plan level</li><li>Three or more years of recent experience in risk adjustment</li><li>Strong understanding of risk adjustment operations and V28 payment model and condition categories</li><li>Knowledge of HIPAA regulations</li><li>Project management and program management experience</li><li>Excellent interpersonal skills to build relationships with clinical and non-clinical personnel</li><li>Strong analytical and creative problem-solving skills</li><li>Proficient in Microsoft Word, Excel, PowerPoint, and Outlook</li><li>Reliable transportation to travel to and from contracted IPAs in Los Angeles County</li></ul>Preferred: <ul><li>Project Management (PMP) Certification, a plus</li><li>Three or more years of health plan experience, highly desired</li><li>Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications</li><li>Knowledge and understanding of ICD-10, CPT and CPT (II), and HCPCS</li></ul><p><br/></p><p> </p><ul></ul>
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