Assistant Program Manager
AECOM
PMP
Risk Score Accuracy Program Manager – Population Health
Bon Secours Mercy Health
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Provides leadership, oversight, coordination, and subject matter expertise for insights related to Population Health Clinical Integration RSA initiatives
- Collaborates with key stakeholders across the Ministry, including BSMH Population Health, Compliance and Revenue Cycle teams, Ensemble, and BSMH physicians and advance care clinicians
- Oversees prospective, concurrent, and retrospective chart reviews for diagnosis coding accuracy
- Supports payer relationships by coordinating chronic condition recapture and suspect condition validation processes
- Collaborates with plan representatives to obtain and analyze RSA gap data
- Facilitates responses to payer-focused HCC validation requests and communicates missed HCC trends to System Director of RSA for dissemination to clinical leadership
- Monitors payer suspect algorithms for potential internal HCC build improvements
- Partners with BSMH Compliance to deliver accurate HCC coding instruction as part of ambulatory provider training and onboarding
- Conducts medical record reviews and analyzes internal data to identify opportunities for real-time training intervention
- Coordinates and participates in collaborative coding forums to share best practices
Requirements
- 5 years of experience progressive responsibility, with risk score accuracy or quality outcomes experience, with a payer or in a healthcare system (required)
- Licensed Professional Coder (CPC) or equivalent (preferred at time of hire, required within one year of hire)
- Certified Risk Coder (or equivalent), Licensed Practical Nurse or other clinical certification (preferred)
- Experience with Epic Electronic Health Record (preferred)
Benefits
- Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
- Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources and discounts
- Paid time off, parental and FMLA leave, shot- and long-term disability, backup care for children and elders
- Tuition assistance, professional development and continuing education support
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
diagnosis coding accuracyHCC codingmedical record reviewsdata analysischronic condition recapturesuspect condition validationrisk score accuracyquality outcomes
Soft skills
leadershipcollaborationcommunicationoversightcoordinationsubject matter expertise
Certifications
Licensed Professional Coder (CPC)Certified Risk Coder
