Manager, Risk Adjustment & Performance - Remote

Overview

The Manager, Risk Adjustment drives process improvements and system enhancements and uses advanced knowledge of healthcare data, systems, and operational processes to serve as subject matter experts across multiple domains to support growth and improvement initiatives for encounters.

In Short

• Monitor overall team performance and project production.
• Collaborate with multiple teams to improve operations.
• Create and conduct risk adjustment training.
• Manage risk adjustment project volumes.
• Evaluate medical records for accuracy of coding.
• Review project performance and escalate trends.
• Ensure compliance with regulatory guidance.
• Support coding and auditing teams.
• Deliver provider audit results with education.
• Maximize health plan reimbursement.

Requirements

• Bachelor's degree or relevant work experience.
• 5+ years in Risk Adjustment Coding and Auditing.
• 2+ years managing teams.
• 4+ years as a subject matter expert in ACA Risk Adjustment.
• 2+ years with EHRs and CCDs.
• Certified Professional Coder (CPC).
• 3+ years leading Risk/Encounter submission process.
• Experience in designing business metrics and dashboards.
• Familiarity with Texas Department of Insurance regulations preferred.
• Strong Excel and PowerPoint skills.

Benefits

• Opportunity to mentor and develop individuals.
• Collaborative and dynamic work environment.
• Passionate team focused on changing healthcare.
• Competitive salary and benefits package.
• Professional development opportunities.
• Transparent and unique culture.