CCHP is seeking a Manager of Risk Adjustment. Gain invaluable experience from working for a small health plan, where you will be an integral part of the organization and contribute to our mission of delivering high-quality, affordable healthcare to the Bay area community. Risk Adjustment Manager is responsible for managing a team of professionals to meet the needs of the Medicare and Marketplace lines of business as it relates to risk adjustment.
The Manager will work in close collaboration with Quality Improvement leadership, and clinical leadership to develop and implement comprehensive strategies to manage and drive improvement in the end-to-end clinical documentation process, from onboarding to claims submission and reporting.
The ideal candidate is a true leader who can train and support their team, willing to step in and be hands-on to help the team succeed. Must be comfortable working with the senior management team, and presenting data/analysis. Flexible with adapting to changes, and a team player to enhance the organizational goals.
Must have three years of experience in clinical Risk Adjustment programs, medicare, and commercial risk adjustment, Risk Adjustment submission to CMS, and HCC coding. Two years of supervisory experience and advanced Microsoft Office skills.
Experience in CRC, process improvement, risk adjustment audits, HEDIS, NCQA helpful, but not required.
Job Type: Full-time
Ability to Commute/Relocate: