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The Consultative Coding Manager manages a diverse team of consultative coders responsible for ensuring clinical documentation supports accurate coding and is reflective of the disease prevalence within the population. The Consultative Coding leader partners with the Divisional Coding Leader to develop market-specific strategies to promote accurate clinical documentation, ensures all state, federal and internal policies and procedures are followed, and fosters collaboration within onshore and offshore coding, audit, and education.
Strategy:
- Cultivate relationships with clinicians (Physicians and Advanced Practice Providers) to serve as the single point of contact for questions and issues relating to documentation and coding.
- In partnership with Divisional Coding Leaders, develops strategy for consultative coding to ensure market needs are being met.
- Cultivates relationships with Divisional Coding Leaders, Market Leaders, and Consultative Coders to share knowledge and best practices.
- Identify and recommend strategies for improving clinical documentation and coding for pre and post visit coding.
Post-Visit/Offshore Coding Collaboration:
- Establish relationship with post-visit/offshore coding leadership.
- Develop continuous quality improvement initiatives.
Mergers and Acquisitions:
- Monitor special handling of mergers and acquisitions.
- Oversee Problem List clean up (as outlined by compliance).
- Ensure PCO process training is performed consistently.
- PCO Process training including but not limited to reporting.
Use your skills to make an impact Required Qualifications:
- Bachelor's Degree or equivalent experience.
- 6+ years of technical experience including Microsoft Office Suite.
- 2+ years of management experience.
- CPC (Certified Professional Coder) Certification.
- RHIA, RHIT, CCS, CPC Certification.
- Medicare Risk Advantage based knowledge and experience.
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
- This position is market-based, and candidates must currently reside in Florida, Georgia, North Carolina or South Carolina.
- Must be able to travel approximately 25%.
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Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$86,300 - $118,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
