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Risk Adjustment Program Coordinator
Location:
Brookfield, WI
Description:
Risk Adjustment Program Coordinator About us Common Ground Healthcare Cooperative is a "who" not a "what." As a cooperative, we are thousands of Wisconsin residents buying health insurance together, supported by a staff focused on providing the best possible service to our members. We are a not-for-profit cooperative, governed by a Board of Directors made up of members who purchase our health insurance. Any earnings are returned to our members in the form of lower prices and better services. Our Culture We are here because we can make a difference in the lives of others. We believe that serving our community is meaningful work and we hold it in the highest regard. We are vibrant, dynamic, and value-focused individuals who welcome different points of view, perspectives, and thoughtful solutions to challenges. We encourage teamwork, integrity, mutual respect, honesty and doing the right thing. We know the importance of showing appreciation for a job well done, celebrate our achievements, and make room for fun and laughter in the workplace. Our Job We are continuously improving our efforts to serve our members and lower their overall healthcare cost through our three key pillars: Advocacy Partnership Innovation. Does this sound like a culture you'd like to be a part of? Come join a fun team of committed professionals! How You'll Make a Difference The primary responsibility of the Risk Adjustment Program Coordinator position is to act as the business unit lead for all matters related to the company's risk adjustment program. This program encompasses medical record retrieval, medical record coding, application of risk adjustment methodologies and analytics, and the risk adjustment data validation (RADV). This position will ensure that the program is run efficiently, achieves its intended outcomes, and incorporates regular process improvements. This will include developing and maintaining a project plan, coordinating that plan within the company's broader project portfolio, and organizing the proper resources when they are needed. The position will be heavily dependent on resources from across the company, so success will require very strong collaboration and communication skills. The Program Coordinator will also be responsible for carrying out specific work tasks to support the various members of the risk adjustment team. Monitoring, and communicating, the updates to the key components of the federal risk adjustment program will be a core responsibility. Utilize Your Skills By: Develop, and continuously update, the documentation that supports the company's risk adjustment program Serve as the primary day-to-day point of contact for CGHC's risk adjustment program vendors Coordinate program activities across multiple departments to assure all activities are planned, resources, and completed Assist with organizing meeting agendas, facilitating business meetings and communications, and tracking the completion of follow-up activities Coordinate transmission of data between CGHC and its vendors, and assist with the organization and storage of all retrieved medical charts per company record retention policy Interact with CGHC's internal medical record coder and provide assistance in obtaining medical charts from CGHC's medical providers when escalation occurs Coordinate the planning, completion, review, and presentation, when necessary, of all data analyses Assist with the oversight of CGHC's retrospective chart chasing process by ensuring the vendor is retrieving the appropriate medical charts Assist with obtaining provider attestations on unsigned medical records Manage the submission of coded medical records to CGCH's RADV audit firm Assist with the development of key performance indicators for the program Track CGHC's progress throughout RA and RADV programs to ensure desired results are realized Assess current processes and recommend/implement improvements, and assist with implementation Assist with communicating status of risk adjustment program to management and identify risks that require escalation Assist with assembly of provider communication/training materials, as needed Coordinate the work of the in-home assessment vendor and administer any associated incentive programs What You'll Need to Bring: Bachelor's degree in business, mathematics, or a related field is required 3 or more years of experience in health insurance Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) Expert level proficiency in Microsoft Office Suite to include Word, Excel, PowerPoint, Outlook, Visio, MS Project, and Adobe Professional Ability to manipulate and interpret reports and data in a variety of formats including but not limited to: PowerBI, Excel and SSRS Ability to develop and implement project plans, influence responsible parties to complete tasks on time, prioritize and accomplish goals Strong interpersonal skills and high level of professionalism Effective listening and critical thinking skills Ability to work independently and within a team Ability to create and maintain excellent working relationships Knowledge of ACA Marketplace and Risk Adjustment principles Effective written and verbal communication skills Ability to work independently and within a team environment Knowledgeable of ICD-9/ICD-10 and CPT codes Demonstrates analytical/problem solving skills to perform a variety of complicated tasks Possesses critical thinking/listening skills General Requirements: Demonstrated adaptability and flexibility to new ideas and approaches. Knowledge of the Affordable Care Act (ACA), especially health plan pricing. Ability to stay organized and synthesize information. Ability to interpret, synthesize and analyze financial information and reports, metrics and other data, arrive at supportable conclusions and recommendations and present to all levels of the organization, formally and informally, at the appropriate level of the audience. Strong verbal and written communication skills, as well as excellent interpersonal skills. Preferred understanding of large group and small group underwriting. We've Got You Covered CGHC offers a comprehensive benefit package and broad range of programs to meet the needs of our employees to help protect your health, wealth, and future. Job Posted by ApplicantPro
Company:
Common Ground Healthcare Cooperative
Posted:
December 26 2023 on ApplicantPro
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More About this Listing: Risk Adjustment Program Coordinator
Risk Adjustment Program Coordinator is a Other Jobs Program Coordinator Job at Common Ground Healthcare Cooperative located in Brookfield WI. Find other listings like Risk Adjustment Program Coordinator by searching Oodle for Other Jobs Program Coordinator Jobs.
Risk Adjustment Program Coordinator is a Other Jobs Program Coordinator Job at Common Ground Healthcare Cooperative located in Brookfield WI. Find other listings like Risk Adjustment Program Coordinator by searching Oodle for Other Jobs Program Coordinator Jobs.