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Manager Hcc Risk Adjustment Jobs in Michigan (NOW HIRING)

MyMichigan Health

HCC Coder

Midland, MI · On-site

$16 - $21.50/hr

Travel to provider office location/offices for HCC education as determined by manager * Mandatory ... Risk Adjustment Factor (RAF) scores (25%) Understands risk adjusted payment methodologies, 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.
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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:
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Manager Hcc Risk Adjustment jobs near you
Risk Adjustment Coding Coordinator (onsite), full time, days

Risk Adjustment Coding Coordinator (onsite), full time, days

Holland Hospital

Holland, MI • On-site

Full-time

Posted 16 days ago

Holland Hospital rating

6.6

Company rating: 6.6 out of 10

Based on 32 frontline employees who took The Breakroom Quiz

647th of 1,002 rated hospitals

Job description

CURRENT HOLLAND HOSPITAL EMPLOYEES- Please apply through Find Jobs from your Workday employee account.
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review, ensuring accurate capture of diagnosis codes, and educating providers. This role partners closely with providers, clinical staff, coding teams and operational leadership to optimize HCC capture and improve documentation integrity.
Qualifications:
Professional coding certification; Certified Risk Adjustment Coder (CRC) strongly preferred or required within 12 months of hire
Experience with risk adjustment programs preferred.
Prior provider education or clinical collaboration experience preferred.
Excellent communication skills for provider education and stakeholder collaboration
Employment Type: Full Time
Shift: Mon-Thrs- 8am-4:30pm Fri- 8a-12p
Weekly Scheduled Hours: 36
Weekend Requirements: NA
Requirements:
- High school diploma/GED or higher education
-Certified Professional Coder (C-CPC)
Clinical Documentation Review & Risk Adjustment Coding
  • Prepare and manage risk adjustment visit workflows, including maintaining patient lists, diagnosis summaries, and assisting with scheduling coordination.
  • Conduct comprehensive pre-visit chart reviews to identify and validate ICD-10-CM diagnoses that accurately represent each patient's health status.
  • Perform post-visit documentation analysis to ensure proper ICD-10-CM code assignment, diagnosis specificity, and compliance with MEAT (Monitor, Evaluate, Assess, Treat) criteria.
  • Maintain up-to-date knowledge of CMS risk adjustment regulations, HCC models, and clinical documentation and coding standards.
  • Support organizational value-based care goals by collaborating with Manager, Quality and clinical teams to ensure compliant risk adjustment documentation.

Provider Engagement, Education & Clinical Support
  • Serve as a clinical documentation and coding subject matter expert, supporting providers in achieving compliant and accurate risk adjustment practices.
  • Deliver ongoing education and feedback to providers and coders regarding documentation standards, diagnosis specificity, and optimal risk adjustment coding principles.
  • Identify documentation gaps or inconsistencies and communicate findings through structured, actionable feedback, including formalized documentation queries as needed.
  • Promote a culture of documentation excellence that supports quality outcomes, operational performance, and compliant value-based care delivery.

Audit, Reporting & Performance Monitoring
  • Conduct routine and targeted chart audits to assess documentation quality, coding accuracy, and HCC recapture performance.
  • Track, analyze, and report key risk adjustment performance indicators, including recapture rates, suspect condition closure, documentation accuracy, and provider-level trends.
  • Collaborate with operational leaders to integrate risk adjustment best practices into existing clinical workflows and identify opportunities for process improvement.
  • Participate in quality assurance initiatives, report findings to leadership, and support the development of corrective action plans or workflow enhancements.

Holland Hospital is an Equal Opportunity Employer, please see our EEO policy

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