Position: Medicare Risk Adjustment Coding Manager
Location: Remote (Must Reside in NY/NJ/CT)
Work Schedule: Monday - Friday, 9:00am - 5:00pm
Compensation: $102,549.17 - $115.367.82 Annual Salary
The Risk Adjustment Coding Manager at VillageCare plays a crucial role in enhancing healthcare quality and operational efficiency. This position is responsible for coordinating Risk Adjustment and Quality coding operations, emphasizing documentation integrity across both areas. The manager will oversee retrospective and prospective chart review programs while supervising the Risk Adjustment coding staff and managing day-to-day vendor operations. Acting as the operational bridge between Risk Adjustment and the HEDIS/Quality abstraction team, the manager ensures that all medical record interactions are utilized effectively for Hierarchical Condition Category (HCC) accuracy and closing quality gaps.
By eliminating redundant provider outreach and maximizing the clinical value of each chart interaction, this role aims to achieve year-over-year improvements in Risk Adjustment accuracy, Risk Adjustment Factor (RAF) performance, and STARs quality measure outcomes, directly impacting patient care and organizational success.
Requirements for this Medicare Risk Adjustment Coding Manager jobTo excel as the Risk Adjustment Coding Manager at VillageCare, candidates must possess a robust set of skills and qualifications. A CPC, CPMA, CRC, CCS-P, CCS, RHIA, or RHIT certification is essential, along with at least five years of experience in Medicare Risk Adjustment coding and familiarity with RADV audits. Proficiency in HEDIS measure specifications and quality gap closure operations is highly preferred. Candidates should have a strong command of ICD-10 and CPT codes, as well as experience using electronic medical record systems.
Excellent communication skills are vital for effectively collaborating within the department and with cross-functional teams. Additionally, a Bachelor's degree in Business Administration, Finance, or a relevant field, or equivalent work experience, is required, ensuring that the candidate is well-equipped to navigate the complexities of healthcare coding and operational management.
Knowledge and skills required for the position are:
- CPC /CPMA/ CRC/ CCS-P/ CCS/ RHIA or RHIT certification.
- Experience with HEDIS measure specifications and quality gap closure operations preferred
- 5+ years of Medicare Risk Adjustment coding including work on RADV audits
- Previous experience using electronic medical record systems.
- Strong knowledge of ICD-10 and CPT codes
- Excellent communication skills to facilitate working with teammates within the department and cross-functional teams.
- Bachelor's degree in Business Administration, Finance or relevant field OR equivalent work experience required
Are you ready for an exciting opportunity?If you have these qualities and meet the basic job requirements, we'd love to have you on our team. Apply now using our online application!
