Risk Adjustment Manager - CoxHealth Plans

CoxHealth

$80K — $95K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Accounting, Finance, Business, or a related field, or 8 years of relevant experience
  • At least 5 years of experience in accounting/finance or a health-related field
  • Experience with risk adjustment programs or managed care is preferred
  • Strong knowledge of regulatory standards related to risk adjustment
  • Previous supervisory experience is preferred

Responsibilities

  • Manage and coordinate risk adjustment programs for Cox HealthPlans
  • Ensure compliance with policies and risk adjustment regulations
  • Analyze risk adjustment models to provide meaningful analytics
  • Develop and execute operational strategies for risk adjustment programs
  • Collaborate with staff and leaders to match risk-adjusted revenue with member health status
  • Maintain accurate records and documentation related to risk adjustment processes
  • Establish and maintain effective working relationships with staff and network providers

Benefits

  • Day shift schedule with set working hours
  • Professional development opportunities
  • Collaborative work environment with leadership involvement
  • Potential for impactful contributions to public health outcomes
  • Focus on compliance and regulation adherence
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, or related field OR 8 years of relevant experience
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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