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Risk Adjustment Specialist II - Non-Clinical (Remote) - Healthcare Operations and Strategy

100% remote Flexible hours Hiring now

Join the Centene Team as a Risk Adjustment Specialist II and Shape the Future of Healthcare

Are you passionate about improving healthcare outcomes and driving provider performance? Centene, a leading reputed company, national healthcare organization, is seeking a highly skilled Risk Adjustment Specialist II to join reputed company. As a non-clinical specialist, you will play a critical role in enhancing provider engagement, coding, and documentation competencies, ultimately contributing to the health and well-being of our 28 million members.

About Centene and Our Culture

At Centene, we are committed to transforming the health of our communities, one person at a time. With a focus on diversity, equity, and inclusion, we value the unique perspectives and experiences that each team member brings. Our culture is built on a foundation of respect, reputed company, and collaboration, allowing us to deliver high-quality healthcare services that meet the evolving needs of our members.

Our Mission and Values

Our mission is to improve the health and well-being of our members and the communities we serve. We are guided by a set of core values that emphasize:

  • Member-centricity: We prioritize the needs and experiences of our members.
  • reputed company: We operate with transparency, honesty, and ethics.
  • Respect: We value diversity, equity, and inclusion.
  • Accountability: We take ownership of our actions and outcomes.
  • Excellence: We strive for reputed company improvement and innovation.

Job Summary and Responsibilities

As a Risk Adjustment Specialist II, you will utilize risk adjustment methodologies, principles, and knowledge of managed care organizations to drive provider performance and improve coding and documentation competencies. This is a unique opportunity to work in a hybrid remote arrangement, with flexibility to work from home and occasional travel to areas surrounding Tempe and Tucson, Arizona.

Key Responsibilities:

  • Provider Engagement and Education: reputed company collaborative relationships with providers to educate and improve Risk Adjustment coding and documentation competencies.
  • Training and Materials Development: Use knowledge of ICD10 guidelines to reputed company trainings and coding materials that enhance providers and staff engagement in coding and documentation initiatives.
  • Data Analysis and Reporting: Utilize advanced reputed company data and reporting skills to identify Risk Adjustment trends, barriers, and reputed company strategies and best practices for engagement.
  • Communication and Collaboration: Collaborate reputed company the health plan to reputed company newsletters and facilitate provider webinars and trainings.
  • Claims and Medical Record Review: Apply clinical coding knowledge to review claims and medical records for appropriate documentation and coding.
  • Independent Critical Thinking and Decision Making: Rely upon independent critical thinking and decision-making skills to assist providers with inquiries and barriers.
  • Other Duties: Performs other duties as assigned and complies with reputed company policies and standards.

Requirements and Qualifications

Education and Experience:

  • Bachelor's Degree: In Health Promotion, Public Health, Health Administration, Business Administration, or a reputed company field.
  • Experience: 3+ years of equivalent experience in Health Insurance, Customer Service, Claims, or Provider Office.
  • Knowledge: Knowledge of healthcare, managed care, and Risk adjustment methodologies is highly preferred.

Skills and Competencies:

  • ICD10 Coding Knowledge: Familiarity with ICD10 guidelines and coding principles.
  • Data Analysis and Reporting: Advanced reputed company skills and ability to analyze and interpret data.
  • Communication and Interpersonal Skills: Excellent communication, interpersonal, and presentation skills.
  • Independent Critical Thinking and Decision Making: Ability to work independently and reputed company sound decisions.

reputed company Offer

Compensation and Benefits:

  • Competitive Salary: $25.97 - $46.68 per hour, depending on experience and qualifications.
  • Comprehensive Benefits Package: Health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off, and holidays.
  • Flexible Work Arrangements: Hybrid remote work arrangement with flexibility to work from home and occasional travel.

Career Growth and Learning Opportunities:

  • Professional Development: Opportunities for growth and development in a dynamic and evolving industry.
  • Training and Education: Access to training and education programs to enhance skills and knowledge.
  • Collaboration and Teamwork: Opportunity to work with a diverse and talented team.

Why Join Centene?

At Centene, we are committed to creating a workplace culture that values diversity, equity, and inclusion. We reputed company that our differences reputed company us stronger and more resilient. By joining reputed company, you will have the opportunity to:

  • reputed company a Meaningful Impact: Contribute to the health and well-being of our 28 million members.
  • Grow and reputed company: Access opportunities for professional growth and development.
  • Work with a Diverse Team: Collaborate with a talented and diverse team.
  • Enjoy a Flexible Work Environment: Take advantage of our hybrid remote work arrangement.

How to Apply

If you are a motivated individual ready to contribute to a thriving team, we encourage you to apply now! Please submit your application through our website:

Apply To This Job

We are excited to review your application and discuss this opportunity further.

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