Director MRA Analytics

People. Passion. Purpose.At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients. We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization, then you should consider joining our team.Overall PurposeThe Director of MRA Analytics will lead a team of analysts to ensure streamlined flow of encounter data from multiple data sources to P3's health plan partners and ultimately to CMS. Additionally, they will work with P3's vendor partners and health plans to build member level insights to inform strategic enterprise and market interventions. This position will be responsible for analytics supporting risk score accuracy to support budgets and quarterly forecasts and interface with various departments across the organization to ensure appropriate explanations of any material variances to expectations. This position requires someone who is adept at problem solving and the ability to communicate effectively with internal & external constituents.Essential FunctionsDashboard Development & MaintenanceWork with vendors and internal teams on ensuring accuracy of data being presentedEnsure continued evolution of dashboard development both externally and internallyEnsure SVP of Healthcare Econ has update and accurate materials to present to Markets, Health Plans, leadership and the Board.Work with the Director of Medicare Programs to manage and maintain the coding dashboardEnd to End Encounter ReconciliationBuild and improve the reconciliation for all encounter data including ASM submissionsEnsure that P3 receives all data from health plans and that P3 vendor partners receive complete data setsManage a team to resolve submission errors and continue to build checks to reduce submission errors including the ability to link supplemental submissions to claimsStrategic Initiative GuidanceRespond to requests for analysis and provide analytic support to the Market Leaders, ELT and external partnersWork with vendors and markets to approve and manage target lists for Chart ReviewsMonitor the performance of the Prospective program to identify areas for improvementWork with Market teams and MRA leadership to identify strategies to implement In Home Assessment initiativesIdentify provider education opportunities based on coding results, queries, prospective performance and/or prevalenceFinancial Insights and ReconciliationManage revenue trend models and identify route cause of developing trends.Manage all analytical audit requests as they relate to Medicare RADV and OIG and prepare financial impacts estimations.Assist in creating the documentation and sign-offs required for SOX Control Audits.Knowledge, Skills, and Abilities Proficiency in SQLData Visualization Experience (Tableau or Power BI)Strong communication and strong written skills as well as proficiency with Microsoft Power PointWorking knowledge of the provider-based healthcare industry, claims processing, provider billing or Risk Adjustment or Medicare Advantage strongly preferredSelf-motivated, creative problem solver who can work independently, see the bigger picture and collaborate through strong communication and interpersonal skillsStrong project management experience and ability to handle multiple projects in a fast-paced environment.Experience At least 5 years previous work experience within risk adjustmentExperience with CMS risk adjustment payment methodologiesEducation Bachelor's degree from an accredited institution.Licenses Credentialed Associate of the Society of Actuaries (ASA) - preferredTravel Details Periodic travel to Corporate HeadquartersAd hoc travel to Markets or other partner locationsWork Location & ScheduleThis role offers either a hybrid or fully remote work arrangement. Candidates within a 50-mile radius of a company office will follow our hybrid schedule, working on-site three days per week. Candidates located outside this radius will work remotely, with occasional travel to offices for meetings or key events.Pay Range: $175,000-190,000 depending on experienceEqual Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThis employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.