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Manager Hcc Risk Adjustment Jobs in Florida (NOW HIRING)

Centrum Health

Risk Adjustment Analyst

Doral, FL · On-site

Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP Quality Reporting PROFESSIONAL COMPETENCIES * Expertise in analytics, statistics, data visualization, or ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

PedIM Healthcare

HCC Coder

Lecanto, FL

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

Lee Health

HCC Coding Educator

Fort Myers, FL · Remote

$27.57 - $35.84/hr

... management teams, and compliance leadership to optimize risk adjustment outcomes and reduce audit ... Minimum of 3 years experience in HCC coding and risk adjustment. Minimum of 3 years experience in ...

Lee Health

HCC Coding Educator

Fort Myers, FL · On-site +1

$27.57 - $35.84/hr

... management teams, and compliance leadership to optimize risk adjustment outcomes and reduce audit ... Experience: Minimum of 3 years' experience in HCC coding and risk adjustment. Minimum of 3 years ...

Msmc

Certified Risk Adjustment Coder

Hialeah, FL

$20.50 - $27.75/hr

Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports * Queries and ... Maintains positive working relationship with Physician Practices, Managed Care and all other ...

Miami Jewish Health

HCC Risk Adjuster and Coder

Miami, FL · On-site

$21.75 - $29/hr

Associate degree in Health Information Management, or specialized training Experience: * A minimum of 1 year of coding experience in Risk Adjustment models and Hierarchical Condition Category (HCC ...

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Manager Hcc Risk Adjustment information

What is the difference between Manager Hcc Risk Adjustment vs Hcc Risk Adjustment Specialist?

AspectManager Hcc Risk AdjustmentHcc Risk Adjustment Specialist
CredentialsTypically requires a bachelor’s degree, industry certifications (e.g., CPC, CCS), and experience in healthcare or risk adjustmentOften requires similar certifications and experience but may have less managerial responsibility
Work EnvironmentSupervises teams, manages projects, and collaborates with multiple departmentsFocuses on data analysis, coding, and risk adjustment tasks, often working independently or in small teams
Employer & Industry UsageCommonly employed by health plans, healthcare providers, and risk adjustment vendorsFound within similar organizations, often as a specialized role supporting risk adjustment processes

The main difference is that the Manager Hcc Risk Adjustment oversees teams and manages projects, while the Hcc Risk Adjustment Specialist focuses on technical tasks like data analysis and coding. Both roles require relevant certifications and industry experience, but the manager role involves leadership responsibilities.

What are the key skills and qualifications needed to thrive as a Manager HCC Risk Adjustment, and why are they important?

To thrive as a Manager HCC Risk Adjustment, you need expertise in healthcare coding (especially ICD-10), risk adjustment methodologies, and a background in health administration or a related field, often supported by a relevant degree and coding certifications like CRC or CPC. Familiarity with risk adjustment analytics platforms, EHR systems, and healthcare data reporting tools is important. Strong leadership, analytical thinking, and effective communication skills enable you to guide teams and collaborate across departments. These skills and qualifications are essential to ensure accurate risk scoring, regulatory compliance, and optimal reimbursement for healthcare organizations.

How does a Manager HCC Risk Adjustment typically collaborate with other departments to ensure accurate risk scoring?

A Manager HCC Risk Adjustment frequently partners with coding teams, clinical staff, and data analysts to ensure that documentation and coding accurately reflect patient conditions for risk adjustment purposes. This collaboration often involves leading training sessions, reviewing charts for compliance, and coordinating audits to identify documentation gaps. Working closely with these departments helps ensure data integrity, optimize risk scores, and support organizational goals related to reimbursement and quality reporting.

What are Manager HCC Risk Adjustment jobs?

Manager HCC Risk Adjustment jobs involve overseeing teams and processes that assess and improve Hierarchical Condition Category (HCC) coding and risk adjustment in healthcare organizations. These managers ensure accurate documentation and coding of patient diagnoses to optimize reimbursement and compliance with government regulations. They collaborate with coders, clinicians, and data analysts to monitor performance, provide training, and implement best practices. Their role is critical in maximizing risk-adjusted revenue while maintaining high standards of patient data integrity.
What are the most commonly searched types of Hcc Risk Adjustment jobs in Florida? The most popular types of Hcc Risk Adjustment jobs in Florida are:
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Manager Hcc Risk Adjustment jobs near you
Risk Adjustment Analyst

Risk Adjustment Analyst

Centrum Health

Doral, FL • On-site

Other

Posted 14 days ago

Job description

SCOPE OF ROLE 

The Risk Adjustment and Analytics Team is working to push boundaries to redefine Risk Adjustment and Quality Analytics in a Value-Based Care Setting. The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk Adjustment and Quality Data and Dashboards for our entire NeueHealth Portfolio: ACA, Medicare, ACO REACH, MSSP, and Medicaid. The Risk Adjustment and Quality Analyst will be responsible for working both independently and collaboratively between multiple departments such as Analytics, Risk Adjustment and Quality, Medical Economics, & Clinical Operations.

This is an onsite position in Doral, FL.

ROLE RESPONSIBILITIES

  • Proactively collaborate and interact with business stakeholders across the organization to understand analytics needs, develop plans to address those needs, and deliver analytics to meet those needs.
  • Using SQL code, mine data on medical spend, clinical data and population health data and derive meaningful insights to improve operations such as trends, correlations and patterns.
  • Own the data. You are responsible for accurate presentation of your data elements, so ensuring data integrity is paramount.
  • Thoroughly analyze data, quickly identify relevant information, and transform it into a meaningful output.  Conduct thoughtful presentations, online or in person, to stakeholders with actionable findings for improvement.
  • Provide concise data reports and clear data visualizations for executive level reporting through Power BI, Excel and other tools used by the organization.
  • Create data processes that are consistent, repeatable, and scalable.
  • Conduct Quarterly Reconciliations to identify dropped HCCs and prepare supplemental data submission files according to payor partner specifications.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • Bachelor's degree is required.
  • Comprehensive understanding of risk adjustment and quality programs across all government-regulated lines of business, including Marketplace, Medicaid, and Medicare programs.
  • Five (5) or more years of hands-on SQL code development is required, including expertise with programming languages like Scala or Python.
  • Three (3) or more years of experience in healthcare field dealing with claims/utilization as it pertains to Risk Adjustment and Quality.
  • Three (3) or more years of analytics experience (Required)
  • Two (2) or more years of Power BI experience (Required)
  • Experience with Databricks (Preferred)
  • Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models
  • Familiarity with HEDIS and MSSP Quality Reporting

PROFESSIONAL COMPETENCIES

  • Expertise in analytics, statistics, data visualization, or programming
  • Dedicates exacting attention to detail and data quality
  • Eager learner, collaborative partner, easy communicator, and careful analyst
  • Passion for empirical research and answering hard questions with data

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