What are the responsibilities and job description for the Risk Adjustment Manager position at Cascade Comprehensive Care Inc?
This position is responsible for supervising and overseeing the activities of Risk Adjustment and HCC review and coding for the organization. This position will also create and monitor action plans to address identified gaps. The position will work collaboratively with internal departments and external stakeholders by performing the following duties.
JOB DUTIES
- Manages the Risk Adjustment and HCC coding program for the organization.
- Performs data analysis to identify key performance indicators to address risk adjustment and HCC coding opportunities.
- Develops and executes action plans for performance improvement based on key indicators to address risk adjustment and HCC coding opportunities which are measurable and actionable solutions to engage providers to improve accuracy of documentation, coding and adoption of best practices.
- Develops risk adjustment strategy and executes on the plan to realize improvements in accuracy and documentation of code capture.
- Directs and manages the risk adjustment program and resources required for successful implementation.
- Builds collaborative relationships with providers to set the stage for successful engagement.
- Educates and assists providers and coders in understanding the HCC Risk Adjustment Program as a payment methodology and the importance of proper chart documentation and code capture.
- Monitors KPI’s through data analytics and identifies providers for Risk Adjustment training, programs and documentation/coding resources.
- Directs and oversees chart audits.
- Provides ICD 10 – HCC coding training to providers and appropriate staff.
- Facilitates coding presentations to clinicians, practice managers and coders.
- Provides feedback to providers and clinic staff regarding performance against KPI’s on documentation practices and compliance with state and federal regulations.
- Stays abreast of trends and regulations to ensure effectiveness and compliance of the Risk Adjustment program.
- Serves as a subject matter expert in documentation and coding to the organization, providers and offices staff.
- Maintains confidentiality and complies with HIPAA rules and regulations.
- Maintains punctual, regular and predictable attendance.
- Works collaboratively in a team environment with a spirit of cooperation.
- Displays excellent communication skills including presentation, persuasion, and negotiation skills required in working with members, providers, and community partners and including the ability to communicate effectively and remain calm and courteous under pressure.
- Respectfully takes direction from manager.
EDUCATION and/or EXPERIENCE
Bachelor’s Degree from four-year college or university and four to six years related experience and/or training; or equivalent combination of education and experience.
COMPUTER SKILLS
Job requires specialized computer skills. Must be adept at using various applications including databases, spreadsheets, report writing, project management, graphics, word processing, presentation creation/editing, communication by email and scheduling software.
We provide a competitive salary and excellent benefits, including vacation, medical, dental and vision insurance, and 401(k) pension plan. To apply for this position, please submit a cover letter and resume. We are an Equal Opportunity Employer.
Job Type: Full-time
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: Hybrid remote in Klamath Falls, OR 97601