Baycare

Manager Risk Adjustment Program

Baycare$85K — $110K *
US-AnywhereRemote in Tampa, FL
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in business, technology, healthcare or related disciplines required
  • Active certification: CPC, CRC, CCS, or RHIT required
  • Minimum of 3 years managing a risk adjustment program or department
  • 5+ years of leadership experience in a healthcare organization
  • Preferred: Master's degree in business, technology, healthcare or related disciplines
  • Preferred: 2+ years of experience in a lead role for Medicare Advantage health plans

Responsibilities

  • Lead and implement risk adjustment strategies and program development
  • Identify opportunities and gaps using provider performance metrics
  • Provide solutions to maintain best-practice documentation and coding
  • Supervise and educate risk adjustment team members on coding responsibilities
  • Work with leadership to evaluate risk adjustment technology solutions

Benefits

  • Remote work option (in-state residency required)
  • Full-time salaried position
  • Commitment to inclusion and belonging
  • Professional development opportunities
  • Supportive work culture focused on trust and respect
Full Job Description
Position details:

Location: Tampa, FL (Remote - Must Reside in the State of Florida)

Status: Full Time, Salaried

Shift Hours: M-F, 8:00 am - 5:00 pm

The Manager Risk Adjustment Program:

  • Leads and implements risk adjustment strategies, operations and program development across BayCare PHSO and BayCare Plus consistent with BayCare goals and objectives.
  • Uses provider performance metrics and data to identify program/provider opportunities and gaps.
  • Works with physician/facility practices and key stakeholders to provide measurable and actionable solutions to meet and maintain best-practice documentation and HCC (Hierarchical Condition Category) and ICD-10 coding practices.
  • As a subject matter expert and preceptor, provides on-going supervision, education and training of risk adjustment team members related to coding and documentation responsibilities.
  • Works with BayCare Leadership to evaluate and adopt risk adjustment technology solutions.

Minimum Qualifications:

Required Education and Credentials: Bachelor's degree in business, technology, healthcare OR related disciplines required; and at least one of the following active certifications: Certified Professional Coder (CPC); Certified Risk Adjustment Coder (CRC); Certified Coding Specialist (CCS); or Registered Health Information Technician (RHIT).

Preferred Education and Credentials: Master's degree in business, technology, healthcare OR related disciplines

Required Experience: Minimum of three (3) years of relevant experience managing a risk adjustment program OR department with direct supervisory responsibility and budgetary accountability required, and minimum of five (5) years of management/leadership experience for a healthcare organization.

Preferred Experience: Two (2) or more years of experience in a lead risk adjustment role working with OR for Medicare Advantage health plans.

*Any equivalent combination of education and experience that provides the required knowledge, skills, and abilities to perform the essential duties and responsibilities of the position.

BayCare Values: Demonstrate a consistent commitment to BayCare Health System's core values of trust, respect, and dignity in all interactions with patients, families, team members, and the community, supporting our shared responsibility to achieve excellence in the communities we serve.

Leadership Competencies

  • Communication: Communicates in a clear, authentic, and transparent manner to meet the needs of others to ensure messages are received and mutually understood.
  • Emotional Intelligence: Demonstrates self-awareness and manages one's emotions. Recognizes and responds constructively to others' emotions and builds meaningful relationships.
  • Talent and Team Development: Develops team members and teams by empowering them, setting clear expectations, providing learning opportunities, and supporting ongoing growth.
  • Change Champion: Demonstrates a commitment to enhance performance by engaging and promoting change, continuous improvement, adaptability, and innovation.
  • Collaboration: Collaborates by sharing responsibility, transparent exchange of information, and collective problem-solving to achieve mutually beneficial solutions.
  • Results Driven: Takes ownership of outcomes by setting clear, measurable goals and aligning team efforts and resources to achieve them.
  • Inclusion and Belonging: Creates an inclusive environment that values all perspectives, respects individuality, and fosters an environment where all feel a sense of belonging.


About Baycare

BayCare Ballpark is a baseball stadium located in Clearwater, Florida, in the United States. The stadium was built in 2004 and has a maximum seating capacity of 8,500 people. The ballpark is the spring training home of the Philadelphia Phillies, and also the home of their Class A affiliate, the Clearwater Threshers of the Florida State League. A sculpture titled The Ace—by artist Kevin Brady—stands at the ballpark's west entrance plaza.
Learn more about Baycare

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