Managed Care Risk Advisor (Apply in minutes)

You could be the one who changes everything for our 28 million members.Centene is transforming the health of our communities, one person at a time.As a diversified, national organization, you’ll have access to competitivebenefits including a fresh perspective on workplace flexibility. Applicants for this job have the flexibility to work remote from home.Candidate must in the state of Arizona and be willing to travel to areassurrounding Tempe and Tucson, Arizona.

• Position Purpose :
• Utilize risk adjustment methodologies, principles, andknowledge of managed care organizations to increase engagement in providerperformance programs utilizing data to develop strategies and best practices.This position will be responsible for driving provider performance byfacilitating provider education trainings on systems and programs. Theposition is responsible for using ICD10 coding and claims knowledge to supportimprovement of coding and medical record documentation of risk adjustedconditions. Position will be responsible for oversight and engagement of70-100 providers.
• Develop collaborative relationships with providers to educate and improve Risk Adjustment coding and documentation competencies.
• Use knowledge of ICD10 guidelines to develop trainings and coding materials that will enhance providers and staff engagement in coding and documentation initiatives.
• Use advanced Excel data and reporting skills to identify Risk Adjustment trends, barriers and develop strategies and best practices for engagement.
• Collaborate within health plan to develop newsletters and facilitate provider webinars and trainings.
• Apply clinical coding knowledge to review claims and medical records for appropriate documentation and coding.
• Rely upon independent critical thinking and decision making skills to assist providers with inquiries and barriers.
• Performs other duties as assigned.
• Complies with all policies and standards.
• EducationExperience :
• Bachelors Degree in Health Promotion, Public Health, Health Administration,Business Administration or related field required : 3 years equivalentexperience in Health Insurance, Customer Service, Claims, or Provider Officerequired : Knowledge of healthcare, managed care, and Risk adjustmentmethodologies is highly preferred. 10% in-state travel required.Pay Range : $25.97 - $46.68 per hourCentene offers a comprehensive benefits package including : competitive pay,health insurance, 401K and stock purchase plans, tuition reimbursement, paidtime off plus holidays, and a flexible approach to work with remote, hybrid,field or office work schedules. Actual pay will be adjusted based on anindividuals skills, experience, education, and other job-related factorspermitted by law. Total compensation may also include additional forms ofincentives.Centene is an equal opportunity employer that is committed to diversity, andvalues the ways in which we are different. All qualified applicants willreceive consideration for employment without regard to race, color, religion,sex, sexual orientation, gender identity, national origin, disability, veteranstatus, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered inaccordance with the LA County Ordinance and the California Fair Chance Act

Salary : $26 - $47