Village Care logo
Village Care

VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

Medicare Risk Adjustment Coding Manager

RiskRiskFull TimeRemoteLeadTeam 1,001-5,000

Location

New York + 2 moreAll locations: New York | New Jersey | Connecticut

Posted

18 days ago

Salary

$102.5K - $115.4K / year

Seniority

Lead

No structured requirement data.

Job Description

Medicare Risk Adjustment Coding Manager

Village Care

Role Description Join VillageCare as a Full-Time Medicare Risk Adjustment Coding Manager and enjoy the thrill of playing a vital role in healthcare's future while working from the comfort of your home. This position offers unparalleled flexibility, allowing you to balance personal and professional commitments seamlessly. The Risk Adjustment Coding Manager at VillageCare plays a crucial role in enhancing healthcare quality and operational efficiency. This position is responsible for: - Coordinating Risk Adjustment and Quality coding operations. - Emphasizing documentation integrity across both areas. - Overseeing retrospective and prospective chart review programs. - Supervising the Risk Adjustment coding staff. - Managing day-to-day vendor operations. - Acting as the operational bridge between Risk Adjustment and the HEDIS/Quality abstraction team. - Ensuring effective utilization of all medical record interactions for Hierarchical Condition Category (HCC) accuracy and closing quality gaps. This role aims to achieve year-over-year improvements in: - Risk Adjustment accuracy. - Risk Adjustment Factor (RAF) performance. - STARs quality measure outcomes, directly impacting patient care and organizational success. Qualifications - CPC, CPMA, CRC, CCS-P, CCS, RHIA, or RHIT certification. - 5+ years of Medicare Risk Adjustment coding experience, including work on RADV audits. - Experience with HEDIS measure specifications and quality gap closure operations preferred. - Strong knowledge of ICD-10 and CPT codes. - Previous experience using electronic medical record systems. - Excellent communication skills to facilitate collaboration within the department and with cross-functional teams. - Bachelor's degree in Business Administration, Finance, or a relevant field, or equivalent work experience required. Requirements - Robust set of skills and qualifications as outlined in the qualifications section. Benefits - Compensation ranges from $102,549.17 to $115,367.82 annually.

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