RN Population Health Risk Adjustment
Banner Health
full-time
Posted on:
Location Type: Remote
Location: Arizona • United States
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Salary
💰 $35 - $59 per hour
About the role
- Serves as a subject matter expert in support of Risk Adjustment Factor (RAF) tools for Banner Medical Group.
- Coordinates the business design, testing and implementation of web-based RAF tools and reports in areas of expertise.
- Monitors and ensures tools are available post implementation.
- Responsible for the development and implementation of Risk Adjustment education and training for network physicians and practices, including documentation and coding requirements, HCCs, HEDIS quality ratings.
- Establishes and promotes a collaborative relationship with physicians, third party vendors, and other members of the health care team.
- Collects and communicates pertinent, timely clinical information to third party vendors and others to fulfill utilization and regulatory requirements.
- Assess accuracy and comprehensiveness of HCC recapture to ensure that diagnosis opportunities are identified timely and appropriately.
- Partners with Risk Adjustment resources to provide guidance on utilization of Risk Adjustment tools.
- Provides formal training and supports physicians and practices in the day to day utilization of Risk Adjustment tools throughout Banner Medical Group.
Requirements
- Must possess a strong knowledge of healthcare provider relations as normally obtained through 3-5 years of related healthcare experience.
- Must possess a current, valid RN license in the state of practice.
- Must demonstrate effective relationship development skills, and ability to effectively communicate in individual and group settings.
- Teamwork is critical.
- Attentive listening and polished presentation skills are needed to effectively educate providers and practices on Risk Adjustment tools.
- Requires critical thinking and project management capabilities.
- Position requires proficiency in personal software applications, including word processing, generating spreadsheets, claims adjudication and provider systems.
Benefits
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Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Risk Adjustment Factor (RAF)HCCsHEDIS quality ratingsdocumentation requirementscoding requirementsproject managementcritical thinking
Soft Skills
relationship developmenteffective communicationteamworkattentive listeningpresentation skills
Certifications
RN license