Remote Risk Adjustment Coder Jobs in Columbia, TN

Why Bookmark Medical?

Bookmark Medical gives new life to primary care clinics in need of tools, resources, and support so they can start delivering the personalized care their communities deserve, while allowing them to thrive in value-based care (‘VBC’). Bookmark Medical is committed to supporting our colleagues by offering competitive benefits that contribute to your overall well-being.

The Provider Network Manager, TN (‘PNM’) will primarily be responsible for affiliate primary care provider / practice performance in our Tennessee affiliate network’s VBC contracts. Additionally, the PNM will oversee affiliate provider relations, which includes developing and maintaining retention strategies for Bookmark Medical in our Tennessee market.

This position will provide the leadership and expertise needed to develop and implement a tactical plan to support the strategic, operational, financial, and clinical objectives of Bookmark Medical in Tennessee. This responsibility will be accomplished in partnership with the VP of Network Development and Strategy, Bookmark Medical Network Leadership, and other key internal stakeholders.

This is a senior role with meaningful opportunity to impact a successful fast-growing primary care affiliate network that values innovation, creativity, and results.

What You Will Do:

• Regularly engage primary care providers / practices, share specific performance data points, and document obstacles / needs within our affiliate provider network
• Review and report out trended performance, making sure improvement is being made against KPI targets in Bookmark’s VBC contracts
• Collaborate with clinical, quality, and risk adjustment leaders to develop strategies and actions to improve provider group/ network performance, as needed
• Advise market leadership and VP of Network Development and Strategy of providers who are at risk of leaving the network and develop plans to retain high performing provider groups
• Continually assess the viability and strengths of the physician network, and identify areas of opportunity, or risk
• Build a culture of accountability and clinical excellence with affiliate providers through strategic coordination and retention of the necessary administrative team, provider team, and staff to achieve Bookmark’s affiliate network goals and objectives
• Maintain comprehensive knowledge on all affiliate providers within assigned region, including key information such as group membership, recent performance trends, and historical contextual elements

Specialized Knowledge and Skills:

• Understanding of the outpatient health care delivery setting; primary care specific knowledge is a plus
• Understanding of value-based care payment / reimbursement models is preferred
• Experience working with physician practices and a demonstrated understanding of practice operations
• Strong communication skills; ability to interact with clinical care team and physicians/providers in appropriate manner
• Excellent organizational capabilities and strong attention to detail
• Leadership skills, ability to influence, form consensus and drive an agenda
• Ability to present information to small and, at times large audiences
• Knowledge of fraud and abuse regulations, health care reimbursement systems, third party payer guidelines, and general coding practices

Education

• Bachelor’s degree in relevant field preferred
• In lieu of a Bachelor’s degree, 5+ years of relevant experience will be considered

Unlock your Benefit Bundle!

Enjoy premium medical coverage with exclusive Revere discounts, a company-funded HSA, plus dental & vision plans to keep you smiling and seeing clearly.
Boost your future with a 401(k) + company match, and rest easy with company-paid life insurance.
Need flexibility? Our Vacation Exchange Program has you covered.
And that’s just the beginning, much more awaits!

Bookmark Medical does not discriminate in employment opportunities or practices on the basis of race, color, religion, gender, national origin, age, physical or mental disability, pregnancy, childbirth or related medical conditions, military service obligations, citizenship, sexual orientation, genetic information, or any other characteristic protected by applicable local, state, or federal law.