Senior Business Counseling Chief – Risk Adjustment Data Analysis & Income Integrity | Remote Opportunity
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Join arenaflex: Shape the Future of Healthcare Data Integrity
Are you a strategic thinker with a passion for transforming complex data into actionable business insights? Do you thrive in leadership roles where you can drive meaningful change across organizations? arenaflex is looking for an experienced Senior Business Counseling Chief to lead our Income Integrity Center of Excellence (COE) within the Risk Adjustment division.
At arenaflex, we believe that data is the foundation of better healthcare decisions. As part of our dynamic team, you will play a pivotal role in ensuring the accuracy, integrity, and optimal utilization of critical healthcare data that impacts millions of lives. This is not just a job—it's an opportunity to make a lasting difference in how healthcare organizations leverage information to improve patient outcomes while maintaining fiscal responsibility.
If you are ready to take your career to the next level with a forward-thinking organization that values innovation, collaboration, and excellence, we invite you to explore this exciting opportunity.
About arenaflex
arenaflex is a leading healthcare innovation company committed to transforming the delivery of healthcare services through technology, data analytics, and strategic insight. We operate at the intersection of healthcare and technology, providing comprehensive solutions that support payers, providers, and patients across the continuum of care.
Our mission is simple: to improve health outcomes while reducing costs through intelligent data management and strategic counseling. We achieve this by assembling world-class talent who share our commitment to excellence and our passion for making a difference.
When you join arenaflex, you become part of a culture that celebrates innovation, Diversity & Inclusion, and professional growth. We understand that our greatest asset is our people, which is why we invest heavily in career development, competitive compensation, and work-life balance.
Position Overview
The Senior Business Counseling Chief will serve as a strategic leader within our Income Integrity Center of Excellence, focusing specifically on Risk Adjustment activities. This role is critical to arenaflex's commitment to data accuracy and financial integrity within our Individual and Family Plan (IFP) portfolio serving approximately one million members.
You will be responsible for driving specialized initiatives including electronic medical record data extraction, reconciliation, and aggregation, as well as financial and operational reporting. This position requires a unique blend of technical expertise, business acumen, and leadership capabilities to effectively guide vendors, external consultants, and cross-functional teams toward shared objectives.
Key Responsibilities
As a Senior Business Counseling Chief at arenaflex, you will:
- Lead Strategic Direction: Provide guidance and direction to external vendors, external consultants, matrixed staff, and internal stakeholders to support Risk Adjustment Income Integrity initiatives. Ensure alignment between business objectives and operational execution.
- Data Reconciliation Excellence: Drive the reconciliation of data from multiple sources, including coding survey results and clinical record images. Identify gaps and inconsistencies while developing and recommending process improvements to enhance efficiency and accuracy.
- System Design & Testing: Act as the business lead for system design efforts and participate in testing new capabilities. Support evaluation activities related to vendor consolidation of coding results and clinical record images, as well as other strategic technical projects.
- Continuous Improvement: Drive change initiatives related to system enhancements and fixes. Understand interdependencies both process-wise and timing-wise to further business objectives and ensure seamless operations.
- Data Interpretation: Utilize your expertise to transform raw data into meaningful and actionable information. Extract insights that drive strategic decision-making across the organization.
- Cross-Functional Coordination: Support coordination across shared services and vendors to ensure data integrity and implement robust data validation processes.
- Audit & Compliance: Manage auditing assignments including documentation and evaluation of critical controls. Ensure adherence to regulatory requirements and internal policies.
- Business Impact Analysis: Understand strategies, results, and business implications. Document and communicate findings in both written and verbal formats to diverse audiences.
- Analytical Framework Maintenance: Conduct periodic updates to analytical schedules and division creation systems. Ensure tools and processes remain current and effective.
- Solution Evaluation: Research and evaluate alternative solutions to address evolving business needs. Recommend innovative approaches that enhance operational effectiveness.
- Vendor Quality Management: Support one million IFP members through rigorous vendor data quality and viability management. Ensure data is properly ingested into systems to drive accurate entries.
- Error Resolution: Analyze and work all validation errors to ensure optimal turnaround and meet submission satisfaction requirements.
- Advanced Analytics: Analyze and understand advanced retrieval techniques to maximize results. Customize ACA reporting perspectives and outreach director information required for daily operational work.
Required Qualifications
To succeed in this role, you must possess:
- Technical Background: Demonstrated experience with IT application development lifecycles, methodologies, and best practices.
- Data Transformation Skills: Proven ability to influence others by transforming complex data into meaningful and actionable information that drives business results.
- Programming Expertise: Strong experience with SAS/SAS EG, Python, and/or SQL Server for data analysis and manipulation. You should be comfortable working with large datasets and performing complex queries.
- Attention to Detail: Exceptional meticulousness with the ability to identify inconsistencies and ensure data accuracy across all deliverables.
- Vendor Management: Proven vendor management experience with the ability to build relationships, negotiate effectively, and ensure performance accountability.
- Communication Skills: Strong verbal and written communication skills with the ability to present complex information clearly to various stakeholders.
- Process Improvement: Experience documenting business processes and recommending/implementing improvement strategies.
- Testing Capabilities: Ability to perform testing functions with a systematic approach to quality assurance.
- System Design Participation: Experience participating in system design initiatives and contributing to technical solutions.
- Validation Skills: Capacity to verify the accuracy of reporting against source documents, reports, and databases.
- Audit Procedures: Ability to implement and execute auditing procedures effectively.
Preferred Qualifications
While not required, the following would strengthen your application:
- Previous experience in healthcare data analytics, particularly in risk adjustment or population health management
- Familiarity with Affordable Care Act (ACA) regulations and IFP (Individual and Family Plan) products
- Experience with electronic health records (EHR) systems and clinical data extraction
- Knowledge of medical coding systems (ICD-10, CPT, HCC)
- Project management certification (PMP, CSM, or equivalent)
- Experience in a remote or distributed work environment
Skills & Competencies
Beyond qualifications, we are seeking a candidate who embodies:
- Strategic Thinking: Ability to see the big picture while managing detailed execution
- Analytical Mindset: Natural curiosity and ability to dig deep into data to find insights
- Leadership Presence: Capability to guide and influence stakeholders at all levels
- Adaptability: Comfortable navigating ambiguity and changing priorities
- Collaboration: Team-oriented approach with ability to work cross-functionally
- Problem-Solving: Creative approach to addressing business challenges
Career Growth & Development
At arenaflex, we are committed to helping our employees grow and advance in their careers. As a Senior Business Counseling Chief, you will have access to:
- Professional Development: Comprehensive training programs and opportunities to enhance your technical and leadership skills
- Career Advancement: Clear pathways for promotion and career progression within the organization
- Mentorship: Access to experienced mentors who can guide your professional development
- Industry Exposure: Exposure to cutting-edge healthcare technologies and methodologies
- Certification Support: Financial assistance for relevant professional certifications
Compensation & Benefits
arenaflex offers a competitive compensation package designed to attract and retain top talent. Our benefits include:
- Competitive Salary: Industry-competitive pay based on experience and qualifications
- Health Insurance: Comprehensive medical, dental, and vision coverage
- Retirement Plans: 401(k) plan with company matching to help you save for retirement
- Paid Time Off: Generous PTO including vacation days, holidays, and sick leave
- Flexible Spending Accounts: Options for FSAs to cover qualified healthcare and dependent care expenses with pre-tax dollars
- Life Insurance: Life insurance coverage to provide financial protection for you and your family
- Employee Assistance Program: EAP services offering support for personal and professional challenges
- Employee Discounts: Discounts on arenaflex products and services
- Wellness Programs: Health and wellness programs promoting employee well-being, including fitness resources
- Tuition Assistance: Educational assistance programs to support your continued learning
- Recognition Programs: Employee recognition programs and incentives celebrating outstanding performance
- Community Engagement: Opportunities to participate in community and volunteer initiatives
- Remote Work Flexibility: Depending on the role and location, options for working from home or flexible schedules
- Diversity & Inclusion: Commitment to fostering a diverse and inclusive workplace where all employees are valued and respected
Work Environment
Our culture is built on collaboration, innovation, and mutual respect. We believe in flexible work arrangements that allow our employees to thrive both professionally and personally. This position offers remote work flexibility, enabling you to work from the comfort of your home while staying connected with your team through advanced collaboration tools.
At arenaflex, we embrace diversity in thought, background, and perspective. We believe that diverse teams drive innovation and deliver better outcomes for our clients and members. We are proud to be an equal opportunity employer committed to creating an inclusive environment for all employees.
Why arenaflex?
When you join arenaflex, you become part of something bigger than yourself. You will work alongside talented professionals who are passionate about transforming healthcare through data-driven insights. You will have the opportunity to make a meaningful impact on the lives of millions of members we serve.
We foster a culture of continuous learning and innovation. Here, your ideas matter, your contributions are recognized, and your career growth is supported. We believe that when our employees succeed, our organization succeeds, and most importantly, the communities we serve benefit.
Apply Today
If you are ready to take the next step in your career and join a team that values excellence, innovation, and integrity, we would love to hear from you. This is your opportunity to contribute to meaningful work while growing professionally in a supportive environment.
Don't miss this chance to make a difference. Apply now to join the arenaflex team!
arenaflex is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.