Risk Adjustment Manager

Risk Adjustment Manager Jobs

What does a Risk Adjustment Manager Do?

Manages an organization's risk adjustment processes to assess patient risk scores and ensure accurate reimbursement calculations. Utilizes patient health factors, their likely use of health care services, and the costs of those services to calculate payment adjustments, forecast revenue impacts, and identify coding gaps. Implements processes and standards to ensure accurate, timely, and compliant reporting to government agencies for determining risk adjustment payments. Monitors risk adjustment performance and leads and executes strategies to optimize financial performance while maintaining re ... gulatory compliance. Requires a bachelor's degree. Typically reports to a director. Manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. More
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Risk Adjustment Manager at Astrana Health

California, CA | Full Time
$125k-162k (estimate)
2 Months Ago
Department. Quality - Risk Adjustment. Location. 600 City Parkway West 10th Floor, Orange, CA 92868. Compensation. $102,000 - $115,000 / year. Description. Manages the risk adjustment initiatives for the organization, including in-home health assessments, embedded NP, medical chart retrieval, HCC risk adjustment data & documentation integrity, and supporting vendor programs. Oversees implementation of programs designed to ensure all diagnosed cod...
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