Risk Adjustment Coding Manager

Job Description:

This position is required to work in a matrixed environment and is responsible for HCC coding activities to support accurate and complete coding within our network provider community.  Additional responsibilities  including goal setting, business planning and contributing participation in strategic initiatives

Responsibilities to include:

• Sets team direction, resolves problems and provides guidance to members of team
• Provides key input to other departments responsible for coding education
• Works with risk adjustment leadership to develop strategies and processes for all risk adjustment models.
• Monitor productivity and implement solutions to optimization coding department
• Quantify ROI on coding products and projects
• Develops, deploys & monitors coding policies and procedures, standards, best practice models for complete, accurate, consistent and timely coding that results in
• Conduct HCC coding  roundtable discussion as needed
• Hire, oversight all coding caregivers within team

Manages all aspects of retrospective review process including oversight of third party contracted vendor, chart abstraction projects and compliance oversight

Primary accountable contact for vendor contracts supporting HCC coding including contract negotiation, setting goals, and tracking performance, and analyzing ROI

Develop team metrics that align with organization strategic initiatives and drive performance

Engage staff in problem solving and process improvement activities to ensure use of resources, and optimal, accurate diagnosis HCC capture

Improve monitoring and auditing protocols to ensure internal and vendor compliance with all applicable regulations and risk adjustment data validation audits (RADV). Respond to and oversee CMS Risk Adjustment Data Validation (RADV) audit requests

Responsible for development of competencies for measuring staff performance and implements action plans based on findings of education/reviews

Cultivates and maintains partnerships and collaborations with internal and external business partners

Minimum Qualifications

• Certified Coding certification through AHIIMA or AAPC
• Demonstrated risk adjustment coding experience
• Demonstrated experience in HCC coding

Preferred Qualifications

• Previous managerial experience
• Bachelor’s degree 
• Demonstrated experience in a Leadership role

Physical Requirements

To see the physical requirements needed to perform the essential functions of this job, please click here.

Location:

Work City:

Work State:

Scheduled Weekly Hours:

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. 

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.