Risk Adjustment Informatics Specialist

Henry-Ford-Health-2; Detroit (MI); On-site; USD 90,000 - 130,000; Full time

Job summary

Henry Ford Health in Detroit is seeking a Risk Adjustment Informatics Specialist to drive complex program analytics and process improvements for Risk Adjustment, HCC coding, and value-based reimbursement initiatives. You will collaborate with clinical, revenue cycle, and executive teams to develop dashboards and reports that track activity and performance.

The role requires a bachelor's degree and at least five years in healthcare or a related setting, with strong quantitative analytics, data

Qualifications

• Bachelor's degree in healthcare, science, business, computer science, or related field.
• Five years of experience in a healthcare or business setting.
• Quantitative analysis experience in data science, including data mining, predictive modeling, and statistics.

Responsibilities

• Conduct complex analytics and process improvements for Risk Adjustment and HCC coding.
• Develop and maintain dashboards reporting Risk Adjustment activities.
• Identify opportunities to improve risk adjustment methodologies and coding practices.
• Serve as SME on risk adjustment, HCC coding, and value-based reimbursement programs.
• Communicate CMS and program updates to ensure compliance and performance.
• Present findings and recommendations to leadership for decision support.

Skills

Quantitative analysis

Data mining

Predictive modeling

Statistical analysis

PowerBI

Education

Bachelor's degree

Master's degree

Tools

PowerBI

Excel

Access

Word

Project

Job description

Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford's care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation's most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus.

Job Description

Role Overview

As a Risk Adjustment Informatics Specialist, you'll play a critical role in driving complex program analytics and process improvements for Risk Adjustment, HCC Coding, and value-based reimbursement programs. You'll collaborate with internal teams to develop dashboards, report on program activities, and identify areas for enhancement. Your expertise will support physicians, clinical leaders, Revenue Cycle leadership, and executive teams in achieving optimal performance and compliance.

Why Henry Ford Health

At Henry Ford Health, we are relentless advocates for exceptional care for our patients, communities, and each other. We come to do meaningful work and grow our careers, and we stay for the connection, support, and shared pride in making the impossible, possible.

What You Will Do

• Conduct complex program analytics and process improvement activities for Risk Adjustment and HCC Coding.
• Develop and maintain program dashboards to report on Risk Adjustment and HCC coding activities.
• Proactively identify areas for improvement in Risk Adjustment methodologies and coding practices.
• Serve as a subject matter expert on Risk Adjustment methodologies, HCC coding, and value-based reimbursement programs.
• Communicate CMS and program requirement updates to ensure continued compliance and optimal performance.
• Present findings and recommendations to leadership for decision support and performance tracking.

What You Will Need

Required Qualifications

• Bachelors degree in healthcare, science, business, computer science, or related field.
• Five (5) years of experience in a healthcare or business setting.
• Quantitative analysis experience in data science, including data mining, predictive modeling, and statistical analysis.
• Extensive knowledge of Risk Adjustment methodologies, HCC coding, and value-based reimbursement programs.
• Proficiency in Microsoft Office (Excel, Access, PowerPoint, Word, Project, PowerBI).

Preferred Qualifications

• Masters degree in healthcare, science, business, engineering, or computer science.
• Seven (7) years of experience in a healthcare or business setting.

What We Offer

At Henry Ford Health, you'll have the opportunity to grow your career through collaboration, mission-driven work, and continuous learning. Join a team that values innovation, excellence, and making a meaningful impact on healthcare.