Full Time Risk Adjustment Auditor Jobs (NOW HIRING)

Position: Medicare Risk Adjustment Coding Manager

Location: Remote (Must Reside in NY/NJ/CT)

Work Schedule: Monday - Friday, 9:00am - 5:00pm

Compensation: $102,549.17 - $115.367.82 Annual Salary

Join VillageCare as a Full-Time Medicare Risk Adjustment Coding Manager and enjoy the thrill of playing a vital role in healthcare's future while working from the comfort of your home. This position offers unparalleled flexibility, allowing you to balance personal and professional commitments seamlessly. Envision being part of a team that prioritizes excellence and customer-centric solutions in the ever-evolving health care landscape, all while residing in the vibrant city of New York, NY. As a key player in our organization, you will lead initiatives that directly impact patient care and financial outcomes. The compensation for this role ranges from $102,549.17 to $115,367.82, reflecting the importance we place on your expertise and leadership.

If you are a smart problem solver with a passion for integrity and high-performance culture, consider applying to be a part of our forward-thinking team.

VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

The Risk Adjustment Coding Manager at VillageCare plays a crucial role in enhancing healthcare quality and operational efficiency. This position is responsible for coordinating Risk Adjustment and Quality coding operations, emphasizing documentation integrity across both areas. The manager will oversee retrospective and prospective chart review programs while supervising the Risk Adjustment coding staff and managing day-to-day vendor operations. Acting as the operational bridge between Risk Adjustment and the HEDIS/Quality abstraction team, the manager ensures that all medical record interactions are utilized effectively for Hierarchical Condition Category (HCC) accuracy and closing quality gaps.

By eliminating redundant provider outreach and maximizing the clinical value of each chart interaction, this role aims to achieve year-over-year improvements in Risk Adjustment accuracy, Risk Adjustment Factor (RAF) performance, and STARs quality measure outcomes, directly impacting patient care and organizational success.

To excel as the Risk Adjustment Coding Manager at VillageCare, candidates must possess a robust set of skills and qualifications. A CPC, CPMA, CRC, CCS-P, CCS, RHIA, or RHIT certification is essential, along with at least five years of experience in Medicare Risk Adjustment coding and familiarity with RADV audits. Proficiency in HEDIS measure specifications and quality gap closure operations is highly preferred. Candidates should have a strong command of ICD-10 and CPT codes, as well as experience using electronic medical record systems.

Excellent communication skills are vital for effectively collaborating within the department and with cross-functional teams. Additionally, a Bachelor's degree in Business Administration, Finance, or a relevant field, or equivalent work experience, is required, ensuring that the candidate is well-equipped to navigate the complexities of healthcare coding and operational management.

Knowledge and skills required for the position are:

• CPC /CPMA/ CRC/ CCS-P/ CCS/ RHIA or RHIT certification.
• Experience with HEDIS measure specifications and quality gap closure operations preferred 
• 5+ years of Medicare Risk Adjustment coding including work on RADV audits 
• Previous experience using electronic medical record systems. 
• Strong knowledge of ICD-10 and CPT codes 
• Excellent communication skills to facilitate working with teammates within the department and cross-functional teams. 
• Bachelor's degree in Business Administration, Finance or relevant field OR equivalent work experience required  

If you have these qualities and meet the basic job requirements, we'd love to have you on our team. Apply now using our online application!