Risk Adjustment Manager - CoxHealth Plans

CoxHealth

$75K — $95K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Accounting, Finance, or Business required
  • Minimum 5 years' experience in accounting/finance, health administration, or related field
  • Preferred experience with risk adjustment programs and compliance in government programs
  • Detail-oriented with a self-starter mentality
  • Previous supervisory experience is a plus

Responsibilities

  • Manage and coordinate risk adjustment programs for Cox HealthPlans
  • Analyze financial aspects of risk adjustment models to ensure accurate revenue alignment
  • Develop and execute operational strategies for risk adjustment processes
  • Ensure compliance with policies and regulations related to risk adjustment
  • Provide meaningful analytics to leadership regarding program effectiveness

Benefits

  • Health, dental, and vision insurance
  • Retirement savings plan
  • Paid time off and holidays
  • Professional development opportunities
  • Collaborative work environment
Full Job Description
Facility:
CoxHealth Plans: 3200 S National Ave, Springfield, Missouri, United States of America, 65807

Department:
1749 CHP Accounting

Scheduled Weekly Hours:
40

Hours:
8:00-4:30

Work Shift:
Day Shift (United States of America)

Job Description:
This professional position is assigned the responsibility and accountability to manage and coordinate the risk adjustment programs for Cox HealthPlans (CHP). This manager will work with other staff and leaders within CHP to ensure risk-adjusted revenue matches members actual health status. Comprehensively understands financial side of risk adjustment models to analyze the program and provide meaningful analytics to leadership and others. From the financial knowledge obtained develops, designs and executes risk adjustment operational strategies and processes. Ensures compliance with all policies and risk adjustment regulations.Education
• Required: Bachelor's degree in Accounting / Finance / Business
Experience
• Required: at least 5 years of experience in accounting/finance, public health, health administration, health insurance or health related field.
• Preferred: Experience with risk adjustment program, government programs compliance, managed care.
Skills:
• Attention to detail and self-starter
• Previous supervisory experience preferred.
• Knowledge of governmental & other regulatory standards, requirements, & guidelines related to risk adjustment and compliance.
• Knowledge of personal computers and software. Knowledge of computerized programs.
• Knowledge of principles of statistics, preferred. Ability to maintain accurate records.
• Ability to communicate effectively, both orally and in writing.
• Ability to establish and maintain effective and cooperative working relationships with staff and network providers.
• Ability to assume responsibility and exercise good judgment in making decisions within the scope of authority of the position.
• Ability to think and work effectively under pressure and accurately complete tasks within established times. Ability to prioritize tasks and meet deadlines.
• Ability to maintain confidentiality.
Licensure/Certification/Registration:
• N/A

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