Risk Adjustment Supervisor - Full-time

metap dir="ltr" style="font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:"Basel Grotesk",Arial,sans-serif;margin:5pt 0px 5pt 0in;padding:0px;"bstrong style="font-size:13.5pt;white-space:pre-wrap;"Position Summary:/strong/b/pp dir="ltr" style="font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:"Basel Grotesk",Arial,sans-serif;margin:5pt 0px 5pt 0in;padding:0px;"span style="white-space:pre-wrap;"The Risk Adjustment Supervisor is responsible for overseeing the performance and operational execution of risk adjustment activities across multiple lines of business, including Medicare Shared Savings Program (MSSP) ACO, REACH ACO, and Medicare Advantage. This role ensures that risk adjustment programs are effectively implemented and that coding accuracy, compliance, and quality standards are maintained to support appropriate revenue capture. The Risk Adjustment Supervisor serves as a subject matter expert and key liaison between internal teams and external partners, driving performance improvement initiatives aligned with CMS and payer-specific guidelines./span/pp dir="ltr" style="font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:"Basel Grotesk",Arial,sans-serif;margin:5pt 0px 5pt 0in;padding:0px;"bstrong style="font-size:13.5pt;white-space:pre-wrap;"Key Responsibilities:/strong/b/pul data-pattern="discCircleSquare" data-depth="1" style="margin:16px 0px;font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:"Basel Grotesk",Arial,sans-serif;padding:0px 0px 0px 32px;list-style-type:disc;"li dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Monitor and manage risk adjustment performance across MSSP ACO, REACH ACO, and Medicare Advantage populations./span/lili dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Analyze and interpret risk score trends, coding accuracy metrics, and clinical documentation to identify opportunities for improvement./span/lili dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Collaborate with clinical, data analytics, health information management (HIM), and provider engagement teams to enhance documentation and coding practices./span/lili dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Coordinate the implementation of risk adjustment strategies, including retrospective and prospective chart reviews, provider education./span/lili dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Ensure compliance with CMS risk adjustment guidelines, HCC coding standards, and payer contractual requirements./span/lili dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Work with external vendors or partners supporting risk adjustment functions, ensuring deliverables meet performance, quality, and compliance expectations./span/lili dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Prepare and present regular performance reports and updates to the Director of Revenue Cycle and other key stakeholders./span/lili dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Stay current with regulatory and policy changes impacting risk adjustment and communicate relevant updates to internal teams./span/lili dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Conducts face to face and virtual meetings with practice stakeholders as needed./span/li/ulp dir="ltr" style="font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:"Basel Grotesk",Arial,sans-serif;margin:5pt 0px 5pt 0in;padding:0px;"bstrong style="font-size:13.5pt;white-space:pre-wrap;"Qualifications:/strong/b/pp dir="ltr" style="font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:"Basel Grotesk",Arial,sans-serif;margin:5pt 0px 5pt 0in;padding:0px;"bstrong style="white-space:pre-wrap;"Required:/strong/b/pul data-pattern="discCircleSquare" data-depth="1" style="margin:16px 0px;font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:"Basel Grotesk",Arial,sans-serif;padding:0px 0px 0px 32px;list-style-type:disc;"li dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Associates Degree/span/lili dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"3+ years of experience in risk adjustment, medical coding, or population health in a Medicare ACO and Medicare Advantage environment. REACH experience preferred./span/lili dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Strong knowledge of CMS-HCC V24 and V28 models, ICD-10 coding, and clinical documentation improvement./span/lili dir="ltr" style="margin-top:5pt;margin-bottom:5pt;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Experience with data analysis and interpreting risk adjustment-related metrics./span/li/ulul data-pattern="discCircleSquare" data-depth="1" style="margin:16px 0px;font-style:normal;font-weight:400;font-size:11pt;line-height:1.38;font-family:"Basel Grotesk",Arial,sans-serif;padding:0px 0px 0px 32px;list-style-type:disc;"li dir="ltr" style="margin-bottom:0in;margin-top:0px;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Certified Risk Adjustment Coder (CRC)/span/lili dir="ltr" style="margin-bottom:0in;margin-top:0px;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Familiarity with EHR systems and risk adjustment analytics platforms./span/lili dir="ltr" style="margin-bottom:0in;margin-top:0px;line-height:1.38;font-size:11pt;"span style="white-space:pre-wrap;"Strong interpersonal and organizational skills with the ability to manage multiple priorities./span/li/ul