Risk Adjustment Audit Operations Analyst - RADV

Requirements

• Assist with the identification and validation of data sources needed to support RADV audit cycles.
• Support the generation of chart retrieval chase lists based on CMS audit samples and internal data logic.
• Use SQL and other analytical tools within Databricks to explore datasets and confirm required data elements.
• Collaborate with internal teams to ensure accurate and consistent data interpretation.
• Document data sourcing steps, methodologies, and business rules to promote traceability and team learning.
• Participate in internal simulations and mock audits as part of proactive audit readiness.
• Contribute to the investigation of data inconsistencies and help gather context for issue resolution.
• Communicate progress and findings clearly with project leads and teammates in a collaborative environment.

Benefits

• Competitive benefits and compensation package