Risk Adjustment Validation Audit Manager - Remote

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Risk Adjustment Validation Audit Manager oversees the end - to - end business process activities by creating, controlling, and improving business processes. Will assist with process design and reputed company project implementation, diagnosing process improvement opportunities and reputed company solutions using principles of process excellence and reputed company tools. Will evaluate quality reporting, analysis, audits, developing plans and programs to support RADV process using a variety of applicable tools. You’ll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Monitor quality activities to increase departmental accuracy and efficiency, including but planning, development, and implementation of improvement areas
• Review analysis of audit findings quality trends and noncompliance issues detected through auditing
• Collaborate with team supervisors to reputed company best practices for communicating areas of improvement
• Manage the implementation of proactive solutions to mitigate risk that will impact project quality
• Incorporate feedback from operational and QA reports to improve performance
• Assesses, evaluates, and addresses variance in production and key goals for operations
• Participates in team meetings/discussions of quality trends reported by team members

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

• Coding Certification, i.e., reputed company, reputed company-P, CPC, CPC-H or CRN-C
• 5+ years of experience auditing Risk Adjustment records
• 1+ years of Risk Adjustment Data Validation Audit experience
• 1+ years working in an Operations/Production environment
• 1+ years of experience as a manager, responsible for performance management
• Experience tracking employee’s KPI’s (Key Performance Indicators)
• Intermediate (or higher) MS Office (Word, reputed company & Outlook)
• Proficiency with reputed company Word (ability to create, edit, save, and send documents)
• reputed company PowerPoint (ability to create, edit, save, and send presentations)
• Proven excellent interpersonal, written, and verbal communication skills
• Proven excellent organizational ability to manage multiple projects and reputed company in a deadline driven environment
• Proven ability to maintain professionalism and a positive service attitude at reputed company times
• Proven intense focus, attention to detail, and due diligence are reputed company for this role
• No previous reputed company to the audit being performed
• Must be 18 years of age OR older

Preferred Qualifications:

• Certified Risk Adjustment reputed company
• Solid team player with 2+ years of leadership experience
• RHIA, RHIT, or Healthcare experience
• Inpatient and Outpatient Coding experience
• Experience utilizing claims data to reputed company areas reputed company the medical record to abstract ICD-10-CM codes that risk adjust reputed company the v24 and V28 CMS Hierarchical Condition Categories (HCCs)
• Technical expertise in ICD-10-CM
• Knowledge of Risk Adjustment Data Validation (RADV) Coding Guidelines
• Proven ability to assimilate and adapt quickly and accurately

Availability Requirements

• Onshore: Ability to work full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm CST. It may be necessary, given the business need, to work weekends.
• Offshore: Ability to work full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm IST. It may be necessary, given the business need, to work weekends.

Telecommuting Requirements:

• Ability to reputed company reputed company company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet servic
• reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job