Manages an organization's risk adjustment processes to assess patient risk scores and ensure accurate reimbursement calculations. Utilizes patient health factors, their likely use of health care services, and the costs of those services to calculate payment adjustments, forecast revenue impacts, and identify coding gaps. Implements processes and standards to ensure accurate, timely, and compliant reporting to government agencies for determining risk adjustment payments. Monitors risk adjustment performance and leads and executes strategies to optimize financial performance while maintaining re ...gulatory compliance. Requires a bachelor's degree. Typically reports to a director. Manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes.More Show Less
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A company is looking for a Manager, Risk Adjustment to oversee performance standards and manage Risk Adjustment Coding and Auditing Programs.Key ResponsibilitiesMonitor team performance, project production, and coding quality to meet industry standards and regulatory deadlinesCollaborate with multiple teams to enhance operations and support business objectivesCreate and conduct training for new hires and existing team members to improve performan...
Job Details. Job Location. 933 Plaza MSO - Pleasanton Rd. San Antonio, TX. Position Type. Full Time. Salary Range. Undisclosed. Job Category. Managed Care. Risk Adjustment Manager. General Summary. This role is key to the success of the Managed Care (MC) Department and is accountable for achieving Risk Adjustment goals and objectives. The Risk Adjustment Manager plans, directs, and coordinates the Risk Adjustment team operations including allocat...
