Director of Risk Adjustment
Company: The Judge Group
Location: Vista
Posted on: June 20, 2022
Job Description:
Location: Vista, CA Description: Our client is currently seeking
a Director of Risk Adjustment located in Vista, CA. This job will
have the following responsibilities:
- Correlates HCC activities, HCC Project Plan, & HCC results to
evaluate outcomes.
- Gains insight to internal physician group HCC activities and
incorporate into HCC - project plan.
- Train all HCC activities for all assigned physician groups and
insure that all tasks are completed in a timely manner.
- Works jointly with senior Health Plan teams to evaluate
training tools and ensure appropriate training of physicians is in
place.
- Manages assigned department staff ensuring timely and accurate
completion of tasks.
- Works jointly with Encounter Data Team to ensure accurate
encounter data transmission processes exist for all groups and
their affiliates capitated hospitals. - Provided solutions to any
issues identified in the encounter data process in order to
minimize or eliminate any negative impact to HCC results.
- Review members' medical records in the Physician, Specialist,
and Inpatient facility office for additional HCC's not submitted by
provider group.
- Takes initiative and is creative an innovative in solving or
recommending ways to solve problems and issues. Qualifications &
Requirements:
- Minimum of five (5) years' experience in working with health
care data such as claims, encounter data, and/or coding.
- Certified Coder or coding experience required.
- Understanding of Risk Adjustment model and HCCs.
- Excellent analytical skills as it relates to health care
data
- Strong management, organization, and decision making skills If
you are interested please contact Ricki Hoffman at 720-463-3580 or
email your resume to ehoffman@judge.com. Contact: This job and many
more are available through The Judge Group. Find us on the web
at
Keywords: The Judge Group, Vista , Director of Risk Adjustment, Executive , Vista, California
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