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Manager Hcc Risk Adjustment Jobs in Kentucky (NOW HIRING)

Robert Half

Financial Manager

Louisville, KY · On-site

$200K - $250K/yr

Monitor portfolio performance, asset allocation, and risk exposure across investment holdings ... Recommend investment decisions, rebalancing actions, and portfolio adjustments based on performance ...

Humana

Transformation Strategy Lead

Louisville, KY · On-site +1

Payor/provider experience, including product design, quality programs, risk adjustment, population health, member / patient engagement, value-based care, or care management * Successful ...

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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?

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 is a Manager HCC Risk Adjustment?

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 popular job titles related to Manager Hcc Risk Adjustment jobs in Kentucky? For Manager Hcc Risk Adjustment jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Manager Hcc Risk Adjustment jobs in Kentucky look for? The top searched job categories for Manager Hcc Risk Adjustment jobs in Kentucky are:
What cities in Kentucky are hiring for Manager Hcc Risk Adjustment jobs? Cities in Kentucky with the most Manager Hcc Risk Adjustment job openings:
Manager Hcc Risk Adjustment jobs near you

Nurse Practitioner - Podiatric Medicine job available in Danville, Kentucky

Upperline Health

Danville, KY • On-site

$84K - $115K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Re-posted 4 days ago

Upperline Health rating

3.5

Company rating: 3.5 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

Job description

A Specialty Path to Good Health
Upperline Health is the nation’s largest provider group dedicated to lower extremity, wound and vascular care. Founded in 2017 with the ambitious goal of transforming specialty care, Upperline Health is a pioneer in bringing value-based care models into specialty care. Upperline delivers a more efficient path for patients to receive consistent and effective treatment for chronic illnesses. 

Triage is temporary. 
Treatment is transformative.
Upperline Health providers coordinate patients’ care among a team of specialists – physicians, advanced practice providers, care navigators, pharmacists, dieticians, and social workers for integrated treatment that addresses patients’ immediate and long-term health needs.

We put patients at the center of value-based care.
Why join our team?
  • Highly competitive salary plus annual bonus opportunity
  • Generous benefit options include comprehensive medical, dental & vision, 401K, PTO and parental leave
  • Continuing Medical Education reimbursement
  • State license reimbursement
  • Highly supportive interdisciplinary team
  • Work Life Balance – regular weekday schedule
  • Rapidly growing company with potential leadership & career growth opportunities
About the Nurse Practitioner (APP) Position
Upperline Health is seeking a Nurse Practitioner to provide clinic-based care in our Danville, KY location and home-based care in the broader Danville area. In collaboration with Upperline’s local Physician team, APPs develop complex plans of care in accordance with the patient’s health status and overall goals and values; provide medical diagnostics and treatments in the clinic, in the patient's home, or via telehealth, consistent with the APP’s scope of practice and the patient’s medical condition; educate patients and families on medication usage, diet & nutrition, and crisis anticipation & prevention. They will also communicate medical information to patients’ physicians, other providers and Upperline’s Physician team and broader interdisciplinary team.
Ideal candidates will have experience with the following: Primary Care/Internal Medicine, geriatric care and/or home-based care, Palliative or Hospice care and/or previously worked in a value-based care environment. Most importantly, candidates must demonstrate compassion for patient needs, have great attention to detail, and thrive in a collaborative environment with rapid growth.
This is a unique opportunity to make a meaningful impact and meet the needs of at-risk patients in both primary and specialty care, with a regular weekday schedule!

What You'll Do:
  • Practice within a unique combination of primary care and specialty podiatric care with the opportunity to grow your skills in both aspects of our value-based care model.
    • Podiatric specifics: 1) provide routine and at-risk foot care including nail & callous debridement, 2) diabetic wound care, and 3) amputation prevention while working within scope and level of experience to manage post-operative patients.
  • Develop and implement clinical plans of care for adult patients facing chronic conditions (e.g., diabetes, COPD, CHF, debility, dementia).
  • Gather patient history, physical exam, and diagnostics within a clinic setting, via telehealth, or within the patient's home.
  • Develop and implement treatment plans given patient’s goals of care and current conditions.
  • Collaborate with the interdisciplinary team to meet the patient and family’s physical as well as psychosocial needs.
  • .Provide compassionate care for our complex patients and their families
  • Educate patients and families about medication usage, side effects, illness progression, diet & nutrition, medical adherence and crisis anticipation & prevention.
  • Communicate with other Upperline clinical team members as well as patient’s community providers, to coordinate optimal care and resources for the patient and their family.
  • Communicate with Upperline’s local physician to review patient records and care plans on a timely basis consistent with state regulations and company standards and policy.
  • Maintain patient medical records and medical documentation consistent with state regulations and company standards and policy.
  • Complete accurate and timely documentation according to risk adjustment standards per education provided.
  • Take part in weekly interdisciplinary team meetings and scheduled education sessions.
  • Provide telephonic support for escalated calls from triage nurse.
  • Participate in continuing education as required by the state Board of Nursing.
  • Prescribe medication as permitted by the state Board of Nursing.
  • Other related duties as deemed necessary.
Required Skills, Education, and Competencies:
  • Master’s degree in nursing required
  • Board Certification as an Adult, Adult-Geriatric or Family Nurse Practitioner required
  • Current Indiana State Registered Nurse & Nurse Practitioner license required
  • Basic Life Support (BLS) certification is required
  • 2 + years nurse practitioner experience in Primary Care/Internal Medicine
  • Value-based care experience preferred
  • Podiatry, orthopedic, wound care and experience with radiologic interpretation, ABIs and injections are a plus
  • Possession of DEA registration or eligibility
  • Must be comfortable providing care in patients homes
  • Previous experience managing, supervising, or coaching clinicians highly preferred
  • A reliable automobile, valid driver’s license and minimum state required liability auto insurance are required; Mileage reimbursement provided
  • Adaptability to thrive is a fast-paced growth-forward environment
  • Experience working in an EMR - AthenaHealth EMR is highly preferred
  • Proficiency using Microsoft Office products
  • Excellent oral and written communication skills to ensure that each of your interactions with patients, family caregivers, clinicians, and team members is effective and meaningful.
Compensation
Compensation is commensurate to compensation for similar positions in the region and based on prior training and experience
Job Type: Full-time

Working Hours

Monday through Friday from 8am - 5pm

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