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Manager Hcc Risk Adjustment Jobs in Michigan (NOW HIRING)

... for risk adjustment and reimbursement purposes. You will play a critical role in translating ... and time management skills * Working knowledge of the business use of computer hardware and ...

Become a part of our caring community The Risk Adjustment Coding Analyst provides operational ... You will manage priorities, meet deadlines, escalate barriers, and make independent decisions ...

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Manager Hcc Risk Adjustment information

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 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 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 popular job titles related to Manager Hcc Risk Adjustment jobs in Michigan?

For Manager Hcc Risk Adjustment jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching Manager Hcc Risk Adjustment jobs in Michigan look for?

The top searched job categories for Manager Hcc Risk Adjustment jobs in Michigan are:

What cities in Michigan are hiring for Manager Hcc Risk Adjustment jobs?

Cities in Michigan with the most Manager Hcc Risk Adjustment job openings:

Auditor, HCC Risk Adjustment Coding

Lansing, MI • On-site

Datavant
Software Development • 51 - 200 employees

$29 - $32/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 9 days ago


Datavant rating

7.1

Company rating: 7.1 out of 10

Based on 103 frontline employees who took The Breakroom Quiz


Job description

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health.

By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare.

What We're Looking For:

As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of a patient's health status and confirming the accuracy of said work.

What You Will Do:

  • Audit coded charts assigned by quality supervisor per the client guidelines

  • Ability to move from different sets of client guidelines with minimal difficulty

  • Maintain a 95% quality average at a diagnosis level

  • Answer rebuttals entered on the auditor by coders and or auditors

  • Participate in weekly coding project review meetings

  • Any other tasks asked by quality supervisor

What You Need to Succeed:

  • 2 years' HCC Coding experience

  • 2 years' HCC Auditing experience

  • Extensive knowledge of ICD -10

  • High school diploma or GED equivalent required

  • AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC)

  • A strong knowledge base of medical terminology, medical abbreviations, pharmacology, and disease processes

  • Ability to work in a fast-paced production environment while maintaining high quality

  • Must be able to follow instructions, meet deadlines and work independently

  • Ability to be flexible in work environment

  • Excellent written and verbal communication skills, ability to work in a remote environment and time management skills

  • Working knowledge of the business use of computer hardware and software to ensure effectiveness and quality of the processing and security of the data

What We Offer:

  • Comprehensive health, dental, and vision insurance

  • Paid time off (PTO) plan

  • Retirement savings plan

  • Flexible work arrangements

  • Opportunities for career growth and development

  • Employee wellness programs

We are committed to building a diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.

At Datavant our total rewards strategy powers a high-growth, high-performance, health technology company that rewards our employees for transforming health care through creating industry-defining data logistics products and services.

The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific job.

The estimated total cash compensation range for this role is:

$29-$32 USD

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

This job is not eligible for employment sponsorship.

Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here (https://www.datavant.com/eeo-commitment-statement) . Know Your Rights (https://www.eeoc.gov/know-your-rights-workplace-discrimination-illegal) , explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay.

At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way.

Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, (https://peopleteam.datavant.com/portal/en/newticket?departmentId=248697000248790029&layoutId=248697000248795462) by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here (https://app.tango.us/app/workflow/Greenhouse--Locating-Requisition-ID-2c7d618c8a8a423da4330ff12330695e) . Requests for reasonable accommodations will be reviewed on a case-by-case basis.

For more information about how we collect and use your data, please review our Privacy Policy (https://www.datavant.com/privacy-policy) .


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