Healthcare Advocate


Portland, ME

Industry: Healthcare


Not Specified years

Posted 235 days ago

  by    Lee Salinis

This job is no longer available.

Judge Healthcare is actively seeking a Healthcare Advocate. This position is field based and we are looking for an individual to travel about 80% of the time across an assigned territory in the Portland, ME area. 

This job will have the following responsibilities: 

  • Travel across assigned territory to meet with providers to discuss improving the quality of care for Medicare Advantage Members. 
  • Will be out in the fi eld 80% of time in defined territory with rare occasion of overnight travel.
  • Utilizing data analysis, identify and target providers who would benefit from training and resources. 
  • Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and hospitals. 
  • Develop comprehensive, provider-specific plans to increase their RAF performance and improve their coding specificity. 
  • Manage end-to-end Risk and Quality Client Programs such as Healthcare Patient Assessment
  • Consult with provider groups 
  • Assists providers in understanding the Medicare quality program 
  • Assist providers in understanding quality and CMS-HCC Risk Adjustment driven payment methodology 
  • Collaborates with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality education efforts Assist in collecting charts

  • Qualifications & Requirements:Bachelor?s degree (preferably in Healthcare or relevant field) OR equivalent work experience REQUIRED
  • Knowledge of ICD10, HEDIS and Stars Experience in Risk Adjustment and HEDIS / Stars REQUIRED
  • Proficiency in MS Office-Excel (Pivot tables, other excel functions), PowerPoint and Word REQUIRED
  • Experience in clinic or hospital and/or managed care PREFERRED 
  • CRC certification Nursing background PREFERRED
  • Experience with coding software, EMR and abstracting systems PREFERRED