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Form of work Superlanet is currently recruiting for a Director Coding Risk Adjustment to support a healthcare organization in Florida. This is a Direct Hire opportunity. This professional will oversee all Risk Adjustment operations across the Center for care Transformation, the BCA CIN Network, and all other value based plans. This position oversees the implementation of all Epic HCC enhancements, developments of dashboards, and presentations to LPG and community physicians for Risk adjustment coding. This position also collaborates with the inpatient coding and claims teams to ensure the Epic BPA is optimized, the codes are present on the submitted claims, and verifies with insurance carriers that they are in fact receiving and accepting these codes with an audit process. Accountable for designing and implementing a system strategy that leads to the overall achievement of improved accuracy, compliancy and completeness in Risk Adjustment initiatives to better support overall population heath management, and reduce gaps in care.
Requirements
- 5+ years of experience in Medicare Risk Adjustment, medical coding, and provider education.
- Maintain certifications necessary to provide professional billing coding support to healthcare professionals to include maintaining or obtaining Healthcare Compliance certification if requested by the hiring department
- Strong leadership skills with the ability to develop and influence teams
- Strong understanding of healthcare operations, encounter and Risk Adjustment data, and the ability to analyze, identify gaps, and recommend strategic initiatives for revenue maximization required.
- Strong organizational, analytical, financial, communication and presentation skills required.
- Proficiency in strategic thinking, problem solving and advanced excel skills required.
- 3 years required of HCC coding.
- 3 years ACO, CIN, Value based experience required.
- 2 years of supervisory/management experience required.
- HEDIS, CAHPS, HOS and Medicare Star or related clinical quality rating data experience required.
Benefits
The salary range below is based on the market rate and is contingent on the organization's requisition and qualifications of the candidate: 87k-118k
