3 VP, Risk Adjustment Jobs in Nashville, TN
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Honest Medical Group is Hiring a VP, Risk Adjustment Near Nashville, TN
Who You Are
You are devoted, compassionate, and enjoy being on the front lines in healthcare, changing the lives of your patients. You are passionate about getting to the root cause of a patient's conditions, removing social determinants of healthcare, and ensuring the highest possible quality of life for those in your care. You don't want to sacrifice quality over quantity, and you aim to provide the same level of care and commitment to your patients that you would to your own family member.
Does this sound like you? If so, we should talk.
Who We Are
We are Honest Medical Group, a groundbreaking team of health care professionals focused on making a major impact in health care. At Honest, we align every aspect of our company to support patients and providers. We are devoted to purpose and inspired by innovation. We embrace our communities and lead with kindness. We drive health improvements, create a seamless member experience, and eliminate unnecessary cost. We listen to the needs of our patients and our employees—continually working to push beyond the status quo.
For us, it's all in an Honest day's work.
Your Role
The VP of Risk Adjustment and CDI will be accountable for managing CDI team, risk adjustment activities, and analytics. This position requires someone who can think strategically and can build out capabilities.
Primary Functions Include:
- Establish technical and procedural infrastructure to support all aspects of risk adjustment (data capture, data analysis, suspecting, and data submission to CMS).
- Develop provider education and expectations, including technical and other tools. Develop, operate, and monitor prospective and retrospective coding processes and programs.
- Establish processes to audit and monitor provider coding practices to ensure compliance with CMS regulations.
- Ensure there is a risk mitigation program.
- Develop and operate member and provider engagement strategies and processes, augmenting routine operations as necessary.
- Establish a modern technological structure and provider contracting model to ensure complete and accurate risk adjustment coding.
- Manage a team of coding specialists, quality educators, and partner-facing leads.
- Oversee management of KPIs and quality of programs, as well as, partner with physician groups and health plans to deliver a best-in-class quality program.
- Secure and oversee prospective, retrospective, and analytical vendors as needed, as well as, the ongoing evolution of Honest programmatics.
- Perform other related responsibilities as required.
How You Qualify
- 10 years of Risk Adjustment or healthcare quality improvement leadership experience required, with 5 a years at national health plan preferred; experience working with provider organization a plus
- Experience with an integrated Value-Based Care model
- Must be a strong public speaker with excellent written and verbal communication skills
- Strong time management, project management, organizational, research, analytical, negotiation, communication, and interpersonal skills
- Demonstrated ability to lead people and get results through others
- Must be able to manage ambiguity and work in fast-paced environment
- Ability to organize and manage multiple priorities
- Excellent internal and external stakeholder relationship management skills
- High level of confidence and interpersonal savvy
- Travel required (Approximately 25%)
How You are Supported
- As a full-time team member, you will benefit from Honest's exceptional total rewards package, including competitive base pay with bonuses, paid time off starting at 4 weeks for full time employees, 12 paid holidays per year, reimbursement for continuing medical education, 401k with match, health, dental, and vision insurance.
- As a part-time team member, you will benefit from Honest's total rewards package, including competitive base pay with bonuses, pro-rated paid time off, paid holidays, reimbursement for continuing medical education, 401k with match.
- Family friendly policies that support paid parental leave and flexible work arrangements
- As a team member you'll be supported by our robust commitment to training and development that starts with onboarding and continues throughout your career with Honest
- You will collaborate with like-minded healthcare professionals who, like you, understand the importance and value of Honest's high-quality, value-based, care model.
Honest is an equal opportunity employer that is committed to inclusion and diversity. We take affirmative action to ensure equal opportunity for all applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics.
Honest is committed to working with and providing reasonable accommodations to job applicants with physical or mental disabilities. Applicants with a disability who require a reasonable accommodation for any part of the application or hiring process should email careers@HonestMedicalGroup.com for assistance. Reasonable accommodation will be determined on a case-by-case basis.
Job Summary
Full Time
$189k-261k (estimate)
11/21/2023
07/04/2024
honestmed.com
San Diego, CA
<25
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