Vacancy expired!
- Implements and manages the strategic plans for the risk adjustment program, including working with leadership on approaches to structure an effective risk adjustment programs in the local market. Ability to work and communicate verbally and written with executive leadership on overall program initiatives, deliverables and status.
- Continually assesses the tactical processes to achieve program objectives and putting in program changes where needed.
- Ensures accurate and complete data capture in all programs; this includes but is not limited to: retrospective and prospective chart reviews and assessment program.
- Create, reviews and maintains operational workflows that are efficient and effective.
- Work with medical leadership to enhance electronic health record systems and tools for physician network to use Develops and implements approaches to measure the effectiveness of physician specific initiatives for improving risk score accuracy.
- Leads staff assigned to risk adjustment; provides guidance and engagement of staff; and builds effective teams (both internally and with vendors) to achieve established goals and within established budgets.
- 5+ years of experience in one or more of the following: Risk Adjustment, Quality/HEDIS, Health Care Finance, Health Care Compliance and/or General Health Plan Operations.
- Demonstrated experience in managing a high-volume workload and meeting tight deadlines.
- Ability to maintain confidential information.
- Working knowledge of Medicare Advantage, Part C & D laws and regulations.
- Familiarity with ICD-10.
- Microsoft Excel proficiency; Microsoft Access preferred.
- Set the bar high for what a company should do
- Create jobs
- Offer people an opportunity to succeed and change their station in life
- Improve the communities where we live and work through volunteering and charitable giving
- Medical Insurance
- Dental Insurance
- Vision Insurance
- 401(k) Plan
- Vacation Package
- Life & Disability Insurance Plans
- Flexible Spending Accounts
- Tuition Reimbursement
Vacancy expired!