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Manager, National Risk EducationPosition Summary:
The Manager, Risk Strategy and National Educator will be responsible for development and implementation of initiatives to improving coding and documentation accuracy for Lumeris clients. This position collaborates with internal teams to develop and implement standardized approaches to Clinical Documentation Improvement and Coding Education as a value-added benefit to Lumeris clients. This position will also collaborate with Clinical Teams (i.e. CMO) to provide Disease Specific Risk Adjustment Training that balances both clinical and coding/documentation focuses. In addition to the develop of the aforesaid collateral, this position will also present to internal and external stakeholders to achieve the department goals for Risk Adjustment Education. Lastly, this position will be responsible for building a team as Lumeris enters new markets and aligns growth with business need.Job Description:
Role and Responsibilities:
- Create and produce standardized coding training and related educational content for internal and external clients. Such content is to be created using industry-standard references and at all times complies with official published guidance per current regulatory / legislative recommendation.
- Delivers training and education in a variety of formats based on client need and internal initiatives. Such formats may include classroom-style education, webinar, audio-conferences or written content.
- Collaborate with internal teams to assure client / project-specific goals are met.
- Functions as a subject matter expertise for company departments requiring expert input for solutions management or analytical purposes.
- Participates in development of organizational procedures and updates of forms, manuals and related tools.
- Regularly interacts with clients to enhance understanding of Clinical Documentation Improvement program goals in order to achieve Risk Adjustment strategic goals and initiatives.
- Provides periodic coding education internally consistent with routine update periods impacting the coding function.
- Maintains current subject matter expertise by attending professional meetings, seminars and related continuing education events.
- Represents Lumeris to the public-at-large by participating in public speaking opportunities at relevant professional meetings.
Experience, Qualifications and Education:
- Bachelor’s degree or equivalent experience
- 6+ years of ICD-9/ICD-10 coding experience including experience in risk adjustment
- Previous experience providing documentation and coding guidance/education to providers
- CPC or CRC certification required
- Additional coding certification such as certification through AHIMA as RHIA or RHIT, CCS or CCS-P preferred
- Knowledge of coding, HCCs, risk adjustments concepts, medical record review project management, encounter data management, compliance audit concepts
- Demonstrated capability to work cross-functionally within corporate matrix environments, confirmed by references who will speak to effective collaboration and partnership on complicated initiatives
- Ability to develop and maintain relationships with a variety of types of positions and individuals at the health plan and health system
- Strong computer skills (i.e. Microsoft Office)
- Strong verbal and written communication skills
- Strong public presentation skills