Job Details

Overview

Description

Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Role

The Risk Adjustment Analytics Principal acts as the primary technical resource and business liaison, working directly with both the Risk Adjustment department and the broader Data Analytics department to develop the tools, metrics, and reports needed to advance the organization's Risk Adjustment strategy. Provides project management and requires the use of advanced analytical and reporting skills and process improvement methodologies to design and review evaluation plans, ensure data collection across groups, influence and develop analysts for reporting support, lead team meetings, and mentor junior staff.

In addition to acting as a technical resource, the Risk Adjustment Analytics Principal also acts as a mentor to caregivers across the Data Analytics department. The Principal must maintain an understanding of the changing health care trends and Risk Adjustment regulations and the impact of such changes on the Plan. The Principal must remain current on analytic techniques and methodologies, data sources, data available within the Providence Health Plan System and other public and proprietary sources. They must also build and maintain relationships with other leaders across the organization including Actuarial, Network, Strategic Accounts, Compliance and Regulatory Finance, IS, Pharmacy, and agencies outside the organization (the State, CMS).

Essential functions

• Meets regularly with Risk Adjustment leadership and staff to establish reporting and analytics priorities, secure resources for required work, establish timelines for successful delivery, and execute on agreed-upon goals.
• Provides deep understanding of Risk Adjustment processes, models, methodologies, and expected outcomes and works with analytics team members to produce reporting and analysis to support decision making by leadership.
• Provides advanced analytical support to both Finance and Risk Adjustment leadership related to performance driving expected payments.
• Organizes, prepares, and distributes complex analyses and operational reports utilizing multiple data systems.

Remote work

Providence Health Plan welcomes 100% remote work for applicants who reside in the following states:

• Washington
• Oregon
• California

Required qualifications

• Bachelor's Degree in a highly quantitative field (e.g. Statistics, Mathematics, Actuarial Science, Economics, Engineering/Physics, Accounting, or Computer Science), plus a minimum of 10 years of experience in data analysis; or High School education or equivalent, plus a minimum of 12 years of experience in data analysis
• Data analysis experience at a decision-making level

Preferred qualifications

• Master's Degree
• Formal training in CQI/TQM and statistical process control methodology
• Healthcare organization/health insurer experience
• Extensive experience in CQI/TQM and statistical process control methodology

Salary Range by Location

• California: Humboldt: Min: $54.40, Max: $85.88
• California: All Northern California - Except Humboldt: Min: $61.04, Max: $96.35
• California: All Southern California - Except Bakersfield: Min: $54.40, Max: $85.88
• California: Bakersfield: Min: $52.19, Max: $82.39
• Oregon: Non-Portland Service Area: Min: $48.65, Max: $76.80
• Oregon: Portland Service Area: Min: $52.19, Max: $82.39
• Washington: Western - Except Tukwila: Min: $54.40, Max: $85.88
• Washington: Southwest - Olympia, Centralia & Below: Min: $52.19, Max: $82.39
• Washington: Tukwila: Min: $54.40, Max: $85.88
• Washington: Eastern: Min: $46.44, Max: $73.31
• Washington: Southeastern: Min: $48.65, Max: $76.80

Why join Providence Health Plan?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

About the Team

Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across multiple states. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

Equal Opportunity

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings free from unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We value diversity and are dedicated to creating equal opportunities for advancement.

Requisition ID: 387087

Company: Providence Jobs

Job Category: Member Services Enrollment & Billing

Job Function: Health Plans Services

Job Schedule: Full time

Job Shift: Day

Career Track: Business Professional

Department: 5018 FINAN FINANCIAL ANALYTICS OR REGION

Address: OR Portland 4400 NE Halsey St

Work Location: Providence Office Park Portland Bldg 1-Portland

Workplace Type: Remote

Pay Range: see posting