Job Details

General Information

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Work Location: Los Angeles, CA, USA

Onsite or Remote

Flexible Hybrid

Work Schedule

Monday-Friday, 8:00am-5:00pm, may require occasional weekend/evening hours

Posted Date

01/08/2026

Salary Range: $78500 - 163600 Annually

Employment Type

2 - Staff: Career

Duration

indefinite

Job #

28410

Primary Duties and Responsibilities

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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

UCLA Health salary range for this title code is $78,500-$163,600/annually. Please note that the department's target pay range is $95,000-125,000/annually.

Job Qualifications

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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

As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.