Demo

HCC Wellness Manager

Regal Medical Group
West Covina, CA Full Time
POSTED ON 2/18/2025
AVAILABLE BEFORE 5/11/2025

Job Description

The Wellness Program / HCC Manager plays a crucial role in overseeing and coordinating care for senior members within the Wellness Program. This position requires a blend of leadership, analytical, and interpersonal skills to effectively manage the program and achieve target goals.

Key Responsibilities

Outreach and Scheduling

  • Manage and oversee the outreach and scheduling of annual wellness visits for Medicare Advantage members
  • Establish relationships with IPA provider offices to coordinate scheduling of annual wellness visits
  • Oversee coordination of rideshares for wellness visits

Team Management

  • Recruit, onboard, and train wellness staff
  • Conduct regular team huddles to monitor progress against performance targets
  • Oversee Wellness teams in North Hollywood and West Covina
  • Reporting and Analytics

  • Monitor and generate productivity reports, wellness visit metrics, completion rates, and risk adjustment reports
  • Present risk adjustment performance reports at monthly provider meetings
  • Develop a reporting platform and track statistical metrics
  • Program Development

  • Collaborate with internal stakeholders to develop marketing collateral and patient-facing materials
  • Create and update workflows, onboarding / training materials, and policies and procedures
  • Assist in developing outreach scripts
  • Quality Assurance

  • Perform medical record audits to ensure proper ICD-10 code capture and documentation support
  • Qualifications and Skills

    Experience and Education

  • 3 years of experience overseeing Medicare risk adjustment programs in a medical group / IPA setting
  • High School Diploma required; Associates or Bachelor's Degree preferred
  • Knowledge of HMO, CPT, HCPCS, Hospital Revenue, and ICD-9 coding
  • Technical Skills

  • Proficiency in EMR systems
  • Strong knowledge of Microsoft Office (Excel, Word, PowerPoint) and Adobe
  • Typing speed of 35 words per minute
  • Personal Attributes

  • Self-starter with the ability to handle multiple tasks
  • Strong analytical and organizational skills
  • Excellent communication skills (both oral and written)
  • Attention to detail and ability to prioritize effectively
  • This role requires a dynamic individual who can effectively manage teams, analyze data, and drive program improvements to enhance the wellness of senior members while meeting organizational goals.

    The pay range for this position at commencement of employment is expected to be $95,000 / year to $100,000 / year however, base pay offered may vary depending on multiple individualized factors, including market location, job related knowledge, licensure, skills, and experience. The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and / or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

    If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department / team performance, and market factors.

    As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, LakesideCommunity Healthcare Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

    Full Time Position Benefits :

    The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.

    Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.

    Health and Wellness :

  • Employer-paid comprehensive medical, pharmacy, and dental for employees
  • Vision insurance
  • Zero co-payments for employed physician office visits
  • Flexible Spending Account (FSA)
  • Employer-Paid Life Insurance
  • Employee Assistance Program (EAP)
  • Behavioral Health Services
  • Savings and Retirement :

  • 401k Retirement Savings Plan
  • Income Protection Insurance
  • Other Benefits :

  • Vacation Time
  • Company celebrations
  • Employee Assistance Program
  • Employee Referral Bonus
  • Tuition Reimbursement
  • License Renewal CEU Cost Reimbursement Program
  • Business-casual working environment
  • Sick days
  • Paid holidays
  • Mileage
  • Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

    Requirements

    Qualifications and Skills

    Experience and Education

  • 3 years of experience overseeing Medicare risk adjustment programs in a medical group / IPA setting
  • High School Diploma required; Associates or Bachelor's Degree preferred
  • Knowledge of HMO, CPT, HCPCS, Hospital Revenue, and ICD-9 coding
  • Technical Skills

  • Proficiency in EMR systems
  • Strong knowledge of Microsoft Office (Excel, Word, PowerPoint) and Adobe
  • Typing speed of 35 words per minute
  • Personal Attributes

  • Self-starter with the ability to handle multiple tasks
  • Strong analytical and organizational skills
  • Excellent communication skills (both oral and written)
  • Attention to detail and ability to prioritize effectively
  • Salary : $95,000 - $100,000

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