Manager, Risk Adjustment & Documentation - Remote

Overview

The Manager of Risk Adjustment & Documentation plays a crucial role in overseeing coding, compliance, and documentation within Health Plan Operations, ensuring effective risk adjustment practices in senior care.

In Short

• Lead risk adjustment operations with a strategic vision.
• Mentor and motivate the coding and medical records team.
• Engage in hands-on coding of medical records.
• Collaborate to build efficient systems and processes.
• Create an accurate pre-enrollment workflow.
• Design engaging educational programs for coding guidelines.
• Conduct audits to identify improvement areas.
• Manage vendor relationships for better outcomes.
• Stay updated on CMS and Medicaid regulations.
• Ensure compliance and ethical practices in documentation.

Requirements

• 7+ years in medical coding or healthcare education.
• Experience with Medicare Advantage or PACE.
• Proven leadership and team management skills.
• Bachelor’s degree in a healthcare-related field.
• CPC or CRC certification required.
• Strong knowledge of Medicare risk adjustment and ICD-10-CM coding.
• Adaptable to a scaling startup environment.
• Excellent strategic problem-solving abilities.
• Effective communication and training skills.
• Tech-savvy with EHR systems and data analysis tools.

Benefits

• Steady Monday through Friday schedule.
• Hybrid work model with in-person and remote options.
• Opportunity to make a significant impact in healthcare.
• Supportive team environment.
• Professional development opportunities.