Risk Adjustment Education Specialist Senior - HP Network

Summary:

The Risk Adjustment Education Specialist Senior will report to the Manager Risk Adjustment Operations and Education. Responsibilities will include provider medical record audits, analysis of practice coding patterns, provider and clinic staff education, and training regarding risk adjustment. Travel will be required, as this is not a remote position.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Work in conjunction with other departments, including Provider Relations, Quality, and the Medical Director, to ensure compliance with CMS risk adjustment guidelines.
• Help train and direct Risk Adjustment Education Specialists and ensure quality of education is up to standard.
• Create and maintain an education onboarding process to ensure all hired Risk Adjustment Education Specialists are equipped to perform their role to full expectations and operate with excellence.
• Develop and maintain technological solutions to report team activity and ensure the solution meets business needs to report transparency of activity.
• Develop and maintain provider education material to direct providers to resources and tools for all Network Documentation Integrity activities.
• Upload and share provider education material for providers to access resources and tools for all Network Documentation Integrity activities.
• Analyze MRA data to identify patterns and development of provider and market-level interventions to coordinate an educational work plan for providers.
• Conduct provider education and training regarding risk adjustment to ensure accurate CMS payment and improve care quality.
• This includes training venues, such as provider offices, hospitals, webinars, conference calls, email correspondence, etc.
• Responsible for building positive relationships with assigned Physicians and serving as a contact for any questions or concerns that may arise.
• Identify those Practices that need initial or ongoing additional training.
• This position does require the ability to have reliable transportation to conduct ongoing face-to-face interactions with Providers.
• Must have strong clinical knowledge of disease pathology and ability to identify clinical indicators related to chronic disease.
• Must be self-motivated; energetic, self-starter; can work autonomously with limited direction.
• Must be results-oriented; bias for action; demonstrated track record of achievement; drive for attainment of superior outcomes.
• Must be analytical, vial research, writing, analytical, and critical reasoning skills.
• Must be a good communicator conveys thoughts and expresses ideas concisely and effectively both verbally and in writing strong presentation skills.
• Must be a good collaborator; orientation to team-based work product and results, open to change and process enhancement.
• Perform other duties as necessary.
• Must possess strong provider-facing skills, which include effective communication, relationship management, and the ability to understand and address provider needs and concerns.

Job Requirements:

Education/Skills
• Associate degree in a relevant field such as health administration, business administration, or related discipline, or similar experience is required.
• Proficiency in healthcare systems and familiarity with policies and procedures is required.
• Proficient in Microsoft Suite applications and open to learning new various systems.

Experience
• 3-5 years of healthcare work experience, including working for a health system, hospital, clinic, physician setting, payer, ACO/CIN, or other similar healthcare institutions required.

Licenses, Registrations, or Certifications
• Certified Risk Adjustment Coder (CRC) from AAPC is required.
• Certified Professional Coder (CPC) preferred.

In accordance with the CHRISTUS Health License, Certification and Registration Verification Policy, all Associates are required to obtain the required certifications for their respective positions within the designated time frame.

Work Schedule:

5 Days - 8 Hours

Work Type:

Full Time