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Hueman Risk Adjustment Solutions Jobs in Arizona

Suvida

Specialist, Quality

Phoenix, AZ · On-site

... or Risk Adjustment experience in supplemental data and chart reviews * Knowledge of CMS STARS ... Strong problem-solving skills with the ability to identify solutions independently and know when to ...

Insight

Solution Principal Sr

Chandler, AZ · On-site +1

As a Fortune 500 Solutions Integrator with deep expertise in cloud, data, AI, cybersecurity, and ... Ensure alignment between pre-sales solutioning and delivery execution to reduce risk and improve ...

Insight Enterprises

Solution Principal Sr

Chandler, AZ · Hybrid

As a Fortune 500 Solutions Integrator with deep expertise in cloud, data, AI, cybersecurity, and ... reduce risk and improve customer outcomes Collaborate cross-functionally with architecture ...

New

Amazon

Operations Center Specialist

Tempe, AZ · On-site

The Sort Center network is the critical Middle-Mile solution in the Amazon Transportation Services ... risk and standardize network response to risk. The NOC Specialist is responsible for managing ...

Deem

Information Security Analyst

Phoenix, AZ · On-site

Using our industry-leading software solutions, employees book travel and car service and report ... risk analysis. * Maintain internal governance and recommend adjustments as threats and practices ...

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Hueman Risk Adjustment Solutions information

What are some typical challenges faced by professionals working in risk adjustment solutions at Hueman, and how can they be addressed?

Professionals in Risk Adjustment Solutions at Hueman often encounter challenges such as accurately interpreting complex medical records and ensuring compliance with evolving healthcare regulations. Maintaining high data quality while meeting deadlines can also be demanding, especially when working with large volumes of patient information. These challenges are best addressed by leveraging advanced coding tools, participating in ongoing training, and collaborating closely with clinical staff and data analysts. This teamwork and commitment to best practices help ensure accurate risk adjustment and contribute to improved patient outcomes.

What is the difference between Hueman Risk Adjustment Solutions vs Medical Coding Specialist?

AspectHueman Risk Adjustment SolutionsMedical Coding Specialist
CredentialsCertifications in risk adjustment, coding, or related fieldsCertified Professional Coder (CPC), CCS, or equivalent
Work EnvironmentConsulting, healthcare analytics, risk adjustment programsHospitals, clinics, insurance companies
Industry UsageHealth plan risk management, analytics firmsMedical billing, coding departments

Hueman Risk Adjustment Solutions focuses on optimizing risk adjustment processes through analytics and consulting, while Medical Coding Specialists handle the accurate coding of medical records. Both roles require coding certifications but differ in scope and work environment, with Hueman primarily providing strategic solutions and Medical Coding Specialists executing coding tasks within healthcare facilities.

What is Hueman Risk Adjustment Solutions?

Hueman Risk Adjustment Solutions is a company that specializes in providing risk adjustment services for healthcare organizations. Their solutions help healthcare providers accurately capture and report patient health data to ensure proper reimbursement and compliance with government programs like Medicare Advantage. They offer services such as coding, chart reviews, and analytics to improve risk score accuracy and optimize revenue cycles. Hueman's approach is designed to enhance the quality of care documentation and support organizations in navigating the complexities of value-based care.

What are the key skills and qualifications needed to thrive as a risk adjustment specialist at Hueman Risk Adjustment Solutions?

To thrive as a Risk Adjustment Specialist, you need a strong background in medical coding, healthcare data analysis, and a comprehensive understanding of risk adjustment models, typically supported by certifications such as CRC, CPC, or CCS. Familiarity with coding software, electronic health records (EHR) systems, and risk adjustment platforms is essential. Attention to detail, analytical thinking, and effective communication are standout soft skills in this role. These skills ensure accurate coding, compliance with regulatory standards, and optimal reimbursement outcomes for healthcare organizations.
What are popular job titles related to Hueman Risk Adjustment Solutions jobs in Arizona? For Hueman Risk Adjustment Solutions jobs in Arizona, the most frequently searched job titles are:
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What cities in Arizona are hiring for Hueman Risk Adjustment Solutions jobs? Cities in Arizona with the most Hueman Risk Adjustment Solutions job openings:
Hueman Risk Adjustment Solutions jobs near you

Specialist, Quality

Suvida

Phoenix, AZ • On-site

Full-time

Medical, Dental, Life, Retirement, PTO

Re-posted 23 days ago

Job description

Who We Are
At Suvida Healthcare, we are not just caregivers; we're compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well-being of an underserved community and their families. Our multi-disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare-eligible Hispanic seniors.
Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both, our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service-centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos, to help achieve our Higher Purpose?
What Makes Us Unique
We are an empowered primary care team, clinical operations, and support team creating health equity through an exceptional clinical and consumer experience that improves the quality of life for the people, families, and neighborhoods we serve. We tailor our primary care program to the culture, language, social, and overall well-being of the seniors we serve.
How We Work
Our Culture & Core Beliefs
  • Earn Trust
  • Building Relationships
  • Creating Joy
  • Doing Right
  • Improving Every Day
  • Moving Forward

Our Promise
  • Purpose Driven Career
  • Competitive Pay
  • Best-In-Class Medical/Dental Coverage
  • Free Mental Health & Life Coaching for Team Members and their Dependents
  • Holiday Time Off with Pay
  • Paid Community Service Day
  • Paid Parental/Family Leave
  • Paid Bereavement Leave
  • Generous Paid Time Off (PTO)
  • 401k Retirement Plan with Company Match
  • And much more....

What You'll Do
Position Summary
The Specialist, Quality will work closely with our clinic staff to identify gaps in care, capture HEDIS documentation, perform chart audits, track patient engagement in care gap, and notify clinics of time sensitive care caps. They will also work with the Director of Quality to report low clinic engagement, opportunities for staff education, and reporting inaccuracies. Essential responsibilities consist of, but are not limited of the following:
Responsibilities
  • Identify and notify clinical staff of next steps needed to address open quality gaps.
  • Submit documentation to payer portal to close quality gaps.
  • Audit supplemental data to ensure results are compliant for identified measures.
  • Educate staff and providers on HEDIS technical specifications.
  • Resolve clinical staff Quality inquiries.
  • Join daily huddles as needed to inform clinical staff of patients with outstanding time sensitive measures.
  • Collaborate with other departments on quality specific projects to help reach quality goals.
  • Actively participate as a team player to promote positive health outcomes for our patients.
  • Able to work Monday-Friday from 8-5PM local time and be in the Arizona area.
  • Be willing to take on additional task to support the overall success of the organization.

What You'll Bring
Education Requirements
  • Bachelor's degree in healthcare administration or public health required

Certifications Requirements
One of the following certifications, accompanied by 2+ years of experience in value-based care setting (primary care or Medicare Advantage Plans preferred):
  • Certified Medical Assistant
  • Certified Pharmacy Technician
  • Certified Nursing Assistant
  • NCQA certification

OR
Experience Requirements
  • 4+ years of experience in value-based care setting (primary care or Medicare Advantage Plans preferred)
  • 2+ years of HEDIS or Risk Adjustment experience in supplemental data and chart reviews
  • Knowledge of CMS STARS program
  • Must have a basic understanding of billing and claims coding
  • Experience reviewing Electronic Medical Records
  • Intermediate level experience in working in Microsoft Excel, Word, and PowerPoint
  • Experience navigating payer portals.
  • At least 1 year of experience utilizing medical terminology.

Skill Requirements
  • Ability to work independently
  • Strong problem-solving skills with the ability to identify solutions independently and know when to appropriately escalate complex issues
  • Ability to multi-task
  • Ability to work in fast paced environments with changing priorities.
  • Bilingual (English/Spanish) preferred

Suvida Healthcare provides equal employment opportunities to all Team Members and applicants for employment and prohibits discrimination and harassment of any type with regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

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