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Permanent Hcc Risk Adjustment Jobs in Virginia (NOW HIRING)

Albanymed

Senior Professional Coder

Broadway, VA · Remote

$64K - $97K/yr

Act as an expert for the HCC/Risk adjustment coding. This position is remote but does require onsite education to providers as needed. Essential Duties and Responsibilities * Review, analyze, and ...

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Permanent Hcc Risk Adjustment information

What is the difference between Permanent Hcc Risk Adjustment vs Permanent Hcc Risk Adjustment?

AspectPermanent Hcc Risk Adjustment

It appears there is a duplication in the comparison question. Assuming the intended comparison is between Permanent Hcc Risk Adjustment and Hcc Coding Specialist, here is the comparison:

AspectPermanent Hcc Risk Adjustment

Permanent Hcc Risk Adjustment involves analyzing and managing patient data to ensure accurate risk scores for insurance purposes, requiring knowledge of medical coding, risk models, and healthcare regulations. An Hcc Coding Specialist focuses on assigning correct diagnosis codes to patient records, often working in similar environments with certifications like CPC. Both roles are essential in healthcare reimbursement and share similar credentials, work settings, and industry usage, but the Risk Adjustment role emphasizes data analysis and risk management, while Coding Specialists focus on accurate coding documentation.

How long does it take to become a permanent Hcc risk adjustment?

Becoming a permanent HCC risk adjustment specialist typically requires gaining relevant experience in healthcare coding, risk adjustment processes, and often obtaining certifications such as the Certified Risk Adjustment Coder (CRC). The timeline can range from several months to a few years depending on prior experience, training, and certification completion, with many professionals advancing within 1-3 years of focused work in the field.

What are the most commonly searched types of Hcc Risk Adjustment jobs in Virginia?

The most popular types of Hcc Risk Adjustment jobs in Virginia are:

What are popular job titles related to Permanent Hcc Risk Adjustment jobs in Virginia?

For Permanent Hcc Risk Adjustment jobs in Virginia, the most frequently searched job titles are:

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The top searched job categories for Permanent Hcc Risk Adjustment jobs in Virginia are:

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Permanent Hcc Risk Adjustment jobs near you

Consulting Actuary - ACA Risk Adjustment

Blue Cross and Blue Shield of North Carolina

Virginia Beach, VA • On-site

$143K - $229K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Re-posted 19 days ago

Blue Cross and Blue Shield of North Carolina rating

7.8

Company rating: 7.8 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

196th of 311 rated insurance

Job description

Job Description

As a Consulting Actuary -ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical services for our organization. Responsibilities include leading pricing strategies and actuarial initiatives for business segments, evaluating advanced care management models, conducting competitive benchmarking analyses, and designing and pricing sophisticated insurance products. You will support company objectives by providing reliable, actionable actuarial insights and recommendations, proactively identifying and addressing complex risks and opportunities. This position requires adaptability to the evolving landscape of the industry, ensuring our actuarial practices remain at the forefront of innovation and excellence.

What You'll Do

  • Accountable for completion of complex actuarial or analytical projects, ensuring timeliness, compliance, and quality of work

  • Provide proactive and strategic thought leadership of ways to improve processes, reduce risks, and meet department and enterprise objectives to achieve profitable growth and/or improve value, quality, and access for Blue Cross NC customers

  • Achieve segment financial targets and provide concise explanations of results and variances to expectations; act as a financial steward for the company

  • Communicate effectively with all levels and divisions within the organization, including Divisional Leadership

  • Manage external partnerships with vendors, auditors, regulators, and health care providers, including effective negotiation of contracts and/or rates

  • Develop and maintain strong business relationships with internal partners through business expertise and exceptional support; act as a strategic advisor

  • Meet continuing education standards required for job function, thought leadership and maintenance of actuarial credentials

What You Bring

  • Bachelor's degree or advanced degree (where required)

  • Member of the American Academy of Actuaries

  • Fellow of the Society of Actuaries

  • 7 years of relevant actuarial experience, related experience may be considered.

  • In lieu of an FSA, will consider candidates who are an Associate of the Society of Actuaries (ASA) and have at least 9 years of relevant actuarial experience.

Bonus Points

  • Deep experience with ACA Risk Adjustment, including HHS-HCC model methodology, risk score forecasting, and financial impact analysis - Highly Preferred

  • Proven expertise in ACA Risk Adjustment transfer forecasting and explanation of results to senior leadership - Highly Preferred

  • Strong understanding of diagnosis coding (ICD-10-CM), provider documentation practices, and their impact on risk adjustment outcomes.

  • Advanced analytical skills to identify risk adjustment leakage, emerging risks, and optimization opportunities across ACA populations

What You'll Get

  • The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community.

  • Work-life balance, flexibility, and the autonomy to do great work.

  • Medical, dental, and vision coverage along with numerous health and wellness programs.

  • Parental leave and support plus adoption and surrogacy assistance.

  • Career development programs and tuition reimbursement for continued education.

  • 401k match including an annual company contribution

  • Learn more

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$143,616.00 - $229,786.00

Skills

Actuarial Analysis, Actuarial Management, Actuarial Science, Actuarial Services, Affordable Care Act (ACA), Complex Care Management, Financial Reporting and Analysis, Hiring Management, Insurance Industry, Organizational Leadership, Regulatory Compliance

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JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

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