New

Medicare Advantage Risk Adjustment Performance Improvement Specialist

University of California - Los Angeles Health
United States, California, Los Angeles
Jan 10, 2026
Description As the Medicare Advantage Risk Adjustment Performance Improvement Specialist, you will be responsible for: Serving as a Subject Matter Expert (SME) for risk adjustment with contracted IPAs Collaborating with IPAs on risk adjustment strategies to achieve health plan goals and KPIs Presenting and managing all risk adjustment programs offered by the health plan Act as a consultant and partner to the contracted IPAs Traveling to contracted IPAs within the Los Angeles County area UCLAHealthsalaryrangeforthistitlecodeis$78,500-$163,600/annually.Pleasenotethatthedepartment'stargetpayrangeis$95,000-125,000/annually. Qualifications We're seeking a self-motivated, detail-oriented individual with: Required: A Bachelor's degree in Health Care Administration, Public Health, Population Health, Finance, Business Analytics or related field and/or equivalent experience Five or more years of experience in healthcare analytics, strategy, and/or consulting at an IPA or health plan level Three or more years of recent experience in risk adjustment Strong understanding of risk adjustment operations and V28 payment model and condition categories Knowledge of HIPAA regulations Project management and program management experience Excellent interpersonal skills to build relationships with clinical and non-clinical personnel Strong analytical and creative problem-solving skills Proficient in Microsoft Word, Excel, PowerPoint, and Outlook Reliable transportation to travel to and from contracted IPAs in Los Angeles County Preferred: Project Management (PMP) Certification, a plus Three or more years of health plan experience, highly desired Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications Knowledge and understanding of ICD-10, CPT and CPT (II), and HCPCS