Francisco Perez
About Francisco Perez
Francisco Perez serves as the Medicare/ACA Risk Adjustment Leader at EmblemHealth, where he has worked since 2019. He holds a Bachelor of Science in Public Administration from John Jay College and has extensive experience in risk adjustment systems and data reporting.
Current Role at EmblemHealth
Francisco Perez currently holds the position of Medicare/ACA Risk Adjustment Leader at EmblemHealth. He has been in this role since 2019, contributing to the organization's efforts in managing risk adjustment processes for Medicare and ACA programs. His responsibilities include directing the extraction and submission of health insurance risk data to federal and state agencies, ensuring compliance with regulatory requirements.
Previous Experience at EmblemHealth
Prior to his current role, Francisco Perez worked at EmblemHealth in various capacities. He served as a Manager of Risk Adjustment from 2016 to 2019, where he managed risk adjustment strategies. Before that, he was a Senior Risk Adjustment Analyst from 2012 to 2016, focusing on data analysis and reporting related to risk adjustment activities. His tenure at EmblemHealth spans over seven years.
Education and Expertise
Francisco Perez studied Public Administration at John Jay College of Criminal Justice, where he earned a Bachelor of Science (BS) degree from 1997 to 2002. He furthered his education at the same institution, achieving a Bachelor of Arts (BA) in Public Administration. He possesses expertise in the CMS Risk Adjustment Processing System (RAPS), Encounter Data System (EDPS), and Health Insurance Exchange (HIX) Risk Adjustment and Reinsurance.
Risk Adjustment Leadership
In his role as Medicare/ACA Risk Adjustment Leader, Francisco Perez develops and executes complex reporting for analytics related to risk adjustment activities. His leadership in this area is crucial for ensuring that EmblemHealth effectively manages its risk adjustment processes, which are vital for financial stability and compliance with healthcare regulations.