ZipRecruiter

Log In

1

Seasonal Hcc Risk Adjustment Coding Jobs in Arizona

Valleywise Health System

CDI Specialist RN Ld

Phoenix, AZ · On-site

$39.96 - $58.94/hr

Advanced knowledge of ICD-10-CM/PCS, MS-DRG/APR-DRG methodologies, risk adjustment, and coding compliance. * Strong clinical validation expertise and critical-thinking skills. * Ability to deliver ...

Adobecw

Strategic Advisor - Contractor

Phoenix, AZ · On-site

$120 - $180/hr

Risk Adjustment (HCC) * Quality Improvement Programs * STARS/HEDIS Initiatives * Gap Closure Programs * Palliative Care * Home‑Based Clinical Services * Remote Patient Monitoring * Respiratory Care ...

previous pagenext page

Showing results 21-40

All JobsHcc Risk Adjustment Coding JobsSeasonal Hcc Risk Adjustment Coding JobsSeasonal Hcc Risk Adjustment Coding Jobs in Arizona

Seasonal Hcc Risk Adjustment Coding information

What are the most common challenges faced by professionals in seasonal HCC risk adjustment coding roles, and how can they be managed?

Seasonal HCC Risk Adjustment Coders often face the challenge of managing high volumes of medical records within tight deadlines, especially during peak audit or submission periods. Ensuring coding accuracy and compliance with evolving CMS guidelines can also be demanding, as even minor errors may impact reimbursement and risk scores. Staying organized, regularly participating in training updates, and leveraging coding software tools can help manage workloads and maintain accuracy. Collaborating closely with clinical teams and other coders is vital for clarifying documentation and sharing best practices.

What is a seasonal HCC risk adjustment coder?

A Seasonal HCC Risk Adjustment Coder is a healthcare professional who reviews medical records to identify and code diagnoses that impact risk adjustment scores, typically during peak periods such as the Medicare Advantage sweep season. HCC stands for Hierarchical Condition Category, a coding system used by Medicare to predict healthcare costs based on patient diagnoses. These coders ensure accurate documentation, which directly affects insurance reimbursement and compliance. Seasonal roles are common due to the cyclical nature of risk adjustment reporting deadlines.

What is the difference between Seasonal Hcc Risk Adjustment Coding vs Hcc Risk Adjustment Coding?

AspectSeasonal Hcc Risk Adjustment CodingHcc Risk Adjustment Coding
CredentialsCertifications in coding and risk adjustmentCertifications in coding and risk adjustment
Work EnvironmentHealthcare facilities, insurance companies, remoteHealthcare facilities, insurance companies, remote
Industry UsageUsed seasonally for specific risk adjustmentsUsed year-round for ongoing risk management
Search IntentUnderstanding seasonal coding differencesGeneral risk adjustment coding practices

Seasonal Hcc Risk Adjustment Coding focuses on coding practices during specific times of the year, often related to seasonal health trends. In contrast, Hcc Risk Adjustment Coding involves continuous coding to manage patient risk profiles throughout the year. Both roles require similar certifications and work environments but differ mainly in their temporal focus and application.

What are the key skills and qualifications needed to thrive as a seasonal HCC risk adjustment coder?

To thrive as a Seasonal HCC Risk Adjustment Coder, you need a strong understanding of ICD-10-CM coding, risk adjustment methodologies, and a certification such as CPC, CRC, or CCS. Proficiency in coding software, electronic health records (EHRs), and risk adjustment platforms is typically required. Attention to detail, analytical thinking, and strong organizational skills help ensure accuracy and compliance in reviewing medical records. These skills are essential to accurately capture patient risk profiles, support healthcare reimbursement, and maintain regulatory compliance.
What are the most commonly searched types of Hcc Risk Adjustment Coding jobs in Arizona? The most popular types of Hcc Risk Adjustment Coding jobs in Arizona are:
What are popular job titles related to Seasonal Hcc Risk Adjustment Coding jobs in Arizona? For Seasonal Hcc Risk Adjustment Coding jobs in Arizona, the most frequently searched job titles are:
What job categories do people searching Seasonal Hcc Risk Adjustment Coding jobs in Arizona look for? The top searched job categories for Seasonal Hcc Risk Adjustment Coding jobs in Arizona are:
What cities in Arizona are hiring for Seasonal Hcc Risk Adjustment Coding jobs? Cities in Arizona with the most Seasonal Hcc Risk Adjustment Coding job openings:
Seasonal Hcc Risk Adjustment Coding jobs near you

Senior Analyst, Risk & Quality Reporting - HEDIS

Molina Healthcare

Chandler, AZ

$60K - $117K/yr

Full-time

Re-posted 26 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 198 frontline employees who took The Breakroom Quiz

163rd of 304 rated insurance

Job description

Job Description

Job Summary

The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause analysis.

Job Duties

  • Works with assigned health plan to capture and document requirements, build custom health plan reports, and educate health plan users on how to use reports
  • Builds intervention strategy reporting for the Risk and Quality interventions and measures gap closure
  • Builds ad hoc reports as requested to track HEDIS performance and supplemental data monitoring
  • Develops and QA custom health plan reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP
  • Develops custom health plan reports related to managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates
  • Assists and collaborates with the national Risk and Quality department with testing of pre-production reporting for the assigned health plan
  • Calculates and tracks gap closure and intervention outcome reporting for the assigned state
  • Works in an agile business environment to derive meaningful information out of complex and large organizational data sets through data analysis, data mining, verification, scrubbing, and root cause analysis
  • Conducts root cause analysis for business data issues
  • Analyzes data sets and trends for anomalies, outliers, trend changes, and opportunities, using databricks SQL, PowerBi, excel, and techniques to determine significance and relevance
  • Assists with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations
  • Key partner to assist with testing changes in the Datawarehouse platform and perform transparent upgrades to reporting modules to ensure no impact to the end users
  • Conducts preliminary and post impact analyses for any logic and source code changes for data and reporting module keeping other variables as constant that are not of focus
  • Develops oneself as a HEDIS subject matter expert to help health plan improve performance on underperforming measures

Job Qualifications

REQUIRED QUALIFICATIONS:

  • Bachelor's Degree or equivalent combination of education and work experience
  • 3-5 years of experience in working with data mapping, scrubbing, scrapping, and cleaning of data
  • 3-5 years of experience in Managed Care Organization executing similar techno functional role that involves writing complex SQL Queries, Functions, Procedures and Data design
  • 3-5 years of experience working with Microsoft T-SQL, Databricks SQL and PowerBI
  • 1-3 years of experience with Microsoft Azure, AWS, or Hadoop
  • 3-5 years of experience in Analysis related to HEDIS and/or Risk Adjustment
  • 3-5 years of experience in working with complex data to include quantifying, measuring, and analyzing financial/performance management and utilization metrics

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing

Molina Healthcare offers a competitive benefits and compensation package Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

What Molina Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Molina Healthcare logo

About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

Social media

FacebookTwitter

View All Molina Healthcare Jobs

Apply