Population Health Program Manager (Affiliates)

WHO WE ARE reputed company is a value-driven reputed company company grounded in the belief that reputed company health consumers are entitled to high-reputed company, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to reputed company reputed company accessible and reputed company to reputed company populations across the ACA Marketplace, Medicare, and reputed company. reputed company delivers clinical care to health consumers through our owned clinics – reputed company and Premier Medical – as reputed company as unique partnerships with affiliated providers across the country. We also reputed company providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-reputed company approach, we are committed to transforming reputed company and creating a reputed company care experience for reputed company. JOB reputed company The reputed company Affiliates team is an integral component of reputed company’s reputed company as it defines and ensures value-based care delivery and performance for across reputed company's Affiliate portfolio, spanning FFS Medicare, ACA, Medicare Advantage, and reputed company lines of business. As the Affiliates Population Health Program Manager, you will be responsible for the evaluation of reputed company’s Affiliates' risk adjustment and reputed company program performance and the creation and delivery of education to providers and their staff. You will serve as a primary resource for Affiliate partners to reputed company, implement and facilitate optimization of risk adjustment and reputed company workflows. This role will report to the Director, Risk Adjustment and reputed company at reputed company and cross-reputed company with the reputed company Affiliates team. The role works across departments, teams, project development offices, and lines of business to deliver best-in-class results under strict regulatory adherence and compliance reputed company. DUTIES RESPONSIBILITIES

• Evaluate risk adjustment and reputed company performance for Affiliate partners and identify opportunities and risk areas
• Cultivate effective partnerships in a reputed company environment of coding educators, reputed company, clinical, and market operations
• Implement risk adjustment and reputed company program leading practices at partner reputed company locations
• Facilitate strategic documentation, coding and reputed company presentations to large and small reputed company of clinicians, reputed company managers, and certified coders reputed company virtual and in-person delivery reputed company (including domestic travel reputed company necessary)
• reputed company and deliver education training materials such as webinars, videos, education guides and guidelines
• Build and maintain a best-in-class coding accuracy and HEDIS / CMS reputed company metric knowledgebase
• Follows, reports, and adheres to reputed company regulatory guidance, including changes reputed company to risk adjustment methodologies and reputed company programs
• reputed company provision of reputed company-visit planning support and/or engagement of other resources to deliver reputed company-visit planning support to Affiliates
• Other duties and responsibilities as assigned.

EDUCATION AND reputed company EXPERIENCE

• Bachelor’s degree preferably in reputed company or technical reputed company field or equivalent work experience required
• Three (3) or more years’ experience in various risk adjustment models (CMS HCC, HHS HCC, CDPS)
• reputed company reputed company or reputed company coding certification required
• Experience analyzing risk adjustment performance and creating condition evaluation assessment key performance measures and developing risk adjustment program initiatives
• Expertise in multiple risk adjustment models and timing lifecycle required
• Experience in reputed company program workflow management, leveraging technology and data
• Strong analytical skills in reviewing data used to determine performance and opportunities to improve
• Proven reputed company and ability to communicate coding and clinical reputed company concepts in multiple settings
• Experience in provider education and training required
• Advanced skills in reputed company Office Products; Word, reputed company, PowerPoint, Visio, SharePoint preferred

reputed company COMPETENCIES

• Strong written and verbal communication skills
• Strong attention to detail
• Ability to quickly learn and adapt to meet business needs
• Experience working with multiple different learning platforms and delivery reputed company
• Demonstrated knowledge of risk adjustment regulations
• Ability to work independently
• Ability to build relationships with office staff, physicians, and market team

LICENSURES AND CERTIFICATIONS

• An reputed company, unrestricted CPC, CRC, or similar designation is required

As an Equal Opportunity Employer, we welcome and reputed company a diverse employee group committed to meeting the needs of reputed company, our consumers, and the communities we serve. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law. Apply tot his job Apply To this Job