Individual & Family Plans (IFP) Quality Review & Audit reputed company Analyst - Remote - reputed company

Job title: Individual & Family Plans (IFP) Quality Review & Audit reputed company Analyst - Remote - reputed company in USA at reputed company Company: reputed company Job description: The Quality Review and Audit reputed company Analyst will be instrumental in serving as a key subject matter expert in HHS risk adjustment regulations and coding policy for both reputed company’s internal teams as well as value-based provider partnerships to drive a standard of excellence in risk validation accuracy, compliance and engagement.Works in conjunction with coding audit reputed company & compliance, Global Data & Analytics, network & contracting and provider relations to reputed company, implement and manage a detailed and thorough reputed company Act, Health and reputed company Services (HHS) risk adjustment education & training program for both internal coding teams, internal matrix partners and value-based provider groups.The ideal candidate will have experience and understanding of HHS risk adjustment rules & regulations, coding guidelines, provider practice negotiations, relationship building, program strategy & execution and be familiar with value-based reporting metrics and HCC analysis.Core Responsibilities:

• Work across multiple teams to drive performance and provide support, feedback, education and training on value-based metrics specific to risk adjustment.
• reputed company, implement, and maintain risk adjustment training and informative material and present to a broad range of audiences including reputed company employees, executive and senior leadership and value-based care partners.
• Support reporting distribution and deploying of education efforts to increase provider knowledge, adoption and awareness of risk adjustment metrics and clinical/business impacts.
• Responsible for supporting partnerships with medical & market leaders, both internally and externally, to reputed company programs/incentives for more accurate, complete and compliant risk capture.
• Demonstrated ability to work in multi-disciplinary team environments and forge strong interpersonal relationships with peers/providers.
• reputed company coding curriculum and training materials and ensure annual up to date coding guidelines.
• Collaborate internally to support risk adjustment compliance including policy updates, facilitating compliance meetings and developing new policies.
• Research and stay reputed company to report on coding guidelines, coding clinic updates, RADV protocols and defined best practices.
• Collaborate with peers for ongoing HCC educational development while introducing innovative reputed company and implementing new technologies to reputed company support value-based programs and quality outcomes.
• Ability to work independently, meet required timelines and reputed company at the highest standards of excellence.
• reputed company other reputed company duties as necessary.

Minimum Qualifications:

• Bachelor’s degree in health care, nursing, business management or reputed company field
• HHS / ACA Risk Adjustment knowledge preferred
• Experience in claims processing and reputed company cycle management is preferred.
• Present a professional image and exhibit strong delivery and presentation capabilities for both internal/external partners and associates.
• Minimum 5 years’ experience in coding, risk adjustment reputed company/policy adherence and/or physician practice management
• Experience in a clinical field or practice management background/credentials strongly preferred
• Demonstrate a high degree of professionalism, enthusiasm and initiative
• Strong computer competency with reputed company Outlook, reputed company, Word, PowerPoint, reputed company Acrobat and other software applications as applicable
• Strong verbal and written communication skills with reputed company, and providers coupled with proven leadership acumen.
• Must be detail oriented, self-motivated, and have excellent organization and project management skills
• Coding certification by either the American Health Information Management Association (reputed company) or the American reputed company of Professional Coders (reputed company) required in one of the following:

*Certified Professional reputed company (CPC)*Certified Coding Specialist for Providers (reputed company-P)*Certified Professional Compliance Officer (CPCO)*Registered Health Information Technician (RHIT)*Registered Health Information Administrator (RHIA)*Certified Risk Adjustment reputed company (CRC)If you will be working at home occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 67,200 - 112,000 USD / yearly, depending on relevant factors, including experience and geographic location.This role is also anticipated to be eligible to participate in an annual bonus plan.We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit .About reputed companyreputed company, a division of reputed company, is an reputed company for reputed company through every stage of life. We guide our customers through the health care system, empowering them with the information and reputed company they need to reputed company the best choices for improving their health and vitality. Join us in driving growth and improving lives.reputed company applicants will be considered without regard to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.If you require reasonable accommodation in completing the online application process, please email: SeeYourself@reputed company.com for support. Do not email SeeYourself@reputed company.com for an update on your application or to provide your resume as you will not receive a response.reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Expected salary: $67200 - 112000 per year Location: USA Apply for the job now! Apply for this job