Director Revenue Projection
CurrentResponsible for financial sweep projection for Medicare Advantage clients.Set up models to forecast risk scores & CMS adjustment revenue at programs and RAPS basis.Provide financial and business analytical decision support for senior management.Performing financial analysis including financial modeling, identify trends and variances, profitability analysis, return on investment, monitoring business issues, and impact of changes to CMS models. Prepare actual and sweep forecast at provider/physician level. Create monthly Medicare new enrollment and disenrollment by plan by Risk Adjustment Factor (RAF) Factor type.· Create CMS-HCC calculation model based on CMS RAP files and comparing against HCC at MOR level to validate missing RAP submission.Monitor and report CMS risk score by states and benefit plans; assess and make recommendation based on the risk score trend for each plan.Lead financial forecast process, identify opportunities for automation processes, and mentor staffs.
