The analyst performs technical services supporting Health Plan operations by monitoring financial solvency through data understanding and future event modeling, interacting with internal/external partners and regulatory agencies. Essential duties include updating analyses for benefit designs, claims experience, and risk adjustment initiatives, while maintaining processes like reserve programs and trend analysis.

The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes submitted to CMS and other government agencies. This role involves performing varied administrative and operational assignments, ensuring coding accuracy is supported by clinical documentation, and following state/federal regulations.

The Manager, Enterprise Risk Management oversees and coordinates the organization’s ERM framework, focusing on risk identification, assessment, and mitigation across the enterprise. This role manages key risk governance processes, business continuity planning, and supports executive and board-level reporting.

Intern supporting Risk Management and Compliance at Grow Financial Federal Credit Union