Risk Adjustment Revenue Manager
Marshfield Clinic Health System
full-time
Posted on:
Location Type: Remote
Location: Remote • Wisconsin • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- The Risk Adjustment Revenue Manager is responsible for risk adjustment strategy and related revenue management for Security Health Plan’s Medicare, Affordable Care Act and Medicaid business.
- This individual provides development and implementation of programs and initiatives to improve the accuracy of the coding, including education; retrospective and prospective review processes; and vendor contract management;
- Accountability for preparation for and management of the Centers for Medicare and Medicaid Services (CMS) and the Department of Health Services (DHS) auditing processes;
- Management of encounter data processes; and management of applicable state and federal guidance.
- The Risk Adjustment Revenue Manager works collaboratively with Security Health Plan executives and leadership as well as Marshfield Clinic Health System (MCHS) executives and leadership to lead risk adjustment strategy and process.
Requirements
- Bachelor’s Degree in Business Administration, Finance, Health Care Administration, Management or related field required.
- Five years of experience in risk adjustment or related area.
- Three years of experience in a management or leadership role and experience in the healthcare industry.
- Demonstrate a broad understanding of healthcare and health insurance.
- Demonstrate proficiency with verbal and written communication, strategic planning and business acumen.
- Certifications in professional coding and risk adjustment coding from American Academy of Professional Coders.
- State of Wisconsin driver’s license with an acceptable driving record.
Benefits
- Benefits for temporary positions vary.
- Details will be discussed in the interview process.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
risk adjustment strategycoding accuracy improvementretrospective review processesprospective review processesvendor contract managementencounter data managementauditing processesstate and federal guidance
Soft skills
collaborationleadershipstrategic planningverbal communicationwritten communicationbusiness acumen
Certifications
professional coding certificationrisk adjustment coding certification