EmblemHealth is one of America’s largest not-for-profit health insurers, serving more than three million people in the New York tristate area. With an 80-year legacy of serving New York communities, EmblemHealth offers a full range of commercial and government-sponsored health plans to employers, individuals, and families.
We started back in the 1930s, at the height of the Great Depression. Out of hard times, the idea of health insurance was born — a system that would protect everyday people from financial misfortune if they had an accident or illness. Two companies from those early days of health insurance, Group Health Incorporated (GHI) and Health Insurance Plan of Greater New York (HIP), would later merge and become EmblemHealth. And after 80 years, our purpose as a not-for-profit is still the same — to provide quality, affordable health insurance for New Yorkers and their families.
The EmblemHealth family of companies provides insurance plans, primary and specialty care, and wellness solutions. The family of companies covers the whole health journey, starting with affordable coverage through EmblemHealth, and ConnectiCare, a leading health plan in Connecticut. The family of companies also includes medicinal practices AdvantageCare Physicians and BronxDocs, occupational health clinic EmblemHealth Health@Work, EmblemHealth Family Dental, and WellSpark Health, a barrier-breaking digital wellness company.
As a family of companies with deep community roots, EmblemHealth Neighborhood Care and ConnectiCare Centers offer free wellness and community resources. Together, the family of companies creates healthier futures for customers and communities.
We think of ourselves as an 80-year-old start-up — big enough to offer the stability and benefits of a major corporation, with a ferocious commitment to innovation, collaboration, and flexibility. We believe in what we’re doing. And we’re looking for passionate people to join us.
Provide complex analytical and reporting/data mining support to the Risk Adjustment Department for Medicare, Medicaid and HIX products. Perform data and analytical services in support of optimizing risk adjusted revenue, maintaining compliance with CMS standards and modeling financial impacts of changes in risk adjustment data and methodologies. Must have strong Risk Adjustment experience/knowledge. Collaborate regularly with internal departments, including but not limited to: Finance, Medicare Operations, Network Management, Provider Contracting, and Health Economics, and external vendors on risk adjustment projects. Organize, prioritize, and manage various simultaneous tasks/projects to meet deadlines. Understand various areas of the business and operational processes relevant to the project’s goals. Provide technical support to leadership on prospective risk adjustment programs.
$63,000/yr - $110,000/yr