Manager, Accountable Care Organization (ACO) Risk Adjustment Programs | Hospital | Maine
Galileo Search is conducting a search for an experienced Manager, ACO Risk Adjustment Programs for one of our preferred client hospitals based in New England. Our client is deeply rooted in the community and focused on delivering high-quality healthcare to every patient that comes through their doors.
Combine a fulfilling career with a living experience that includes enhanced quality of life in a town with a strong sense of community, and you have a recipe for success. This vibrant area receives high marks for housing and overall livability; you will find this to be the perfect location for the next step in your career!
Key Responsibilities and Duties:
• Implements and manages the work plans for the risk adjustment program, including working with leadership on approaches to structure an effective risk adjustment programs
• Responsible for facilitating the development and monitoring effectiveness of workflows and the overall accuracy and completeness of the medical record
• Manages the development of provider and care team education and training programs related to complete and accurate diagnosis coding
• Partners with medical group leaders to identify opportunities for improvement and implement best practices
• Works with appropriate teams and leadership to design actionable, accurate performance reporting that reflects the key processes and outcome measures
• Develop and support forums for review of Risk Adjustment key metrics with front line care teams and managers
• Finds opportunities for incorporation of quality gap closure into HCC gap closure workflows and collaborates with appropriate leadership to develop workflows
• Works collaboratively with Clinical Informatics and Revenue Cycle teams to align initiatives and ensure appropriate and complete data flow
• Leads staff assigned to risk adjustment; provides guidance and engagement of staff; and builds effective teams to achieve established goals and within established budgets
• Serves as the risk adjustment expert in the organization and remains up to date on industry best practices
• Maintains expert knowledge of the risk adjustment process, including regulatory changes impacting the program
• Medical coding certification required (CPC, COC, CIC, CCS-P or CCS) - CRC preferred or ability to obtain within 1 year of hire
• 3-5 years of experience in Medicare Risk Adjustment
• 2+ years of people management experience desired
• Knowledge of diagnoses/procedures in accordance with current ICD coding principles
• Experience in the areas of provider relations, education and training of providers and medical office staff\
• Experience working across sectors, and/or in a highly complex, matrixed organization. Excellent organizational, project and program management skills
• Experience leading change and implementing programs
• Strong quantitative and analytical skills
• Demonstrated ability to be an effective, collaborative partner with internal and external stakeholders
• Excellent written and verbal communication skills
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