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Mgr Risk - PHM

Expired Job

Usmd Health System Irving , TX 75061

Posted 7 months ago

Job Purpose:

The SeniorCare Manager will support all clinical initiatives related to Risk Adjustment Coding for SeniorCare and will ensure that clinics are following the processes and procedures. This individual will work with providers and staff to ensure accurate coding and will be a resource to the clinics and the SeniorCare team for all items related to Risk Adjustment. The SeniorCare Manager will oversee operational framework focused on scalable and repeatable best practices as it relates to Risk Adjustment.

Minimum Requirements:

Education & Qualifications:
Bachelor's Degree in Nursing required (8 or more years of additional experience beyond the required years of experience may be substituted in lieu of a bachelor's degree)

Required Licenses/Certifications: RN License, CPC certification or proof that certification has been obtained within 9 months from the American Academy of Professional Coders required.

Work Experience: 5 years of General Clinical experience required.

Two years of clinical coding experience with strong attention to detail and a high level of accuracy.

Essential Duties and Responsibilities:

  • Effectively coordinates and develops the strategic planning for the RAF department.

  • Oversight of the RAF/HCC team, including scheduling of activities, evaluations and onboarding of new staff.

  • Maintains staff by recruiting, selecting, orienting and training employees.

  • Accomplishes staff results by communicating job expectations, planning, monitoring and appraising job results, coaching, counseling, and disciplining employees; developing, coordinating and enforcing systems, policies, procedures, and productivity standards.

  • Establishes strategic goals; identifies and evaluates trends and options; choosing a course of action, defining objectives; evaluating outcomes.

  • Incorporates principles of adult learning in the planning, implementation, and evaluation of education programs using a variety of strategic tools.

  • Assess provider and staff participation in risk coding processes to identify best practices.

  • Educate practitioners/clinical staff and provide ongoing clinical guidance related to the Risk Adjustment process.

  • Work collaboratively with Population Health Management leadership in the development of program success metrics and ongoing performance metrics.

  • Provide strong leadership and judgment; effectively build and deepen relationships across USMD marketplace.

  • Create a team-oriented work climate that enables professional development and encourages creative solutions and strategies, establishes collaboration and emphasizes quality and cost.

  • Maintain compliance with AAPC coding standards and CMS Risk Adjustment guidelines.

  • Assists with orientation of new staff to the organization.

  • Develops and coordinates education plans related to initial and ongoing competency validation.

  • Plans, prepares and maintains materials for use in educational programs for accuracy and relevance to the target audience.

  • Facilitates teambuilding and leadership development

  • Integrates ethical principles in all aspects of practice

  • Serves as a role model for education and professional nursing practice

  • Performs other duties as assigned

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Mgr Risk - PHM

Expired Job

Usmd Health System