Principal RAS Partner & Educator

Lumeris; United States; Remote; USD 98,000 - 132,000; Full time

Benefits offered by this job

Medical, Vision and Dental Plans

401k with company match

Paid Time Off

Employee Assistance Program

Job summary

Lumeris is seeking a Principal RAS Partner & Educator to lead Risk Adjustment initiatives for our clients, advancing coding accuracy and education programs. You will develop, deliver and monitor training across providers, collaborate with internal teams, and ensure strategic goals are met while maintaining outstanding client service; this role is remote in the United States.

The position requires 8+ years in healthcare, strong data skills, and the ability to translate complex regulatory guidance

Qualifications

• Bachelor’s degree in health administration, business administration or related field or equivalent.
• 8+ years of experience within Healthcare, Health plan, or Health System required, including payer, hospital, Medicaid/Medicare, provider environment or managed care or the knowledge, skills, and abilities to succeed in the role
• Knowledge of Risk Adjustment Payment methodologies and understanding of the CMS HCC, HHS, and Medicaid
• Excellent presentation skills, comfortably delivering educational presentations in large settings or 1:1, regardless of the format
• Track record of creating Coding Documentation Improvement (CDI) collateral, presentations and other educational tools
• Strong aptitude for critical thinking and data skills with the proven ability to identify, develop, communicate, implement, and impact process improvements and strategic initiatives
• Proven ability to create results, prioritize workload, and respond to changing demands/timelines in a dynamic environment
• Proficiency in Microsoft Office Programs including Word, PowerPoint, Excel, and Outlook
• Excellent interpersonal and communication skills with the ability to collaborate and work through all professional levels, internally and externally

Responsibilities

• Owns and manages a comprehensive Risk Adjustment strategy for our clients by developing effective risk adjustment operating plans and developing and implementing of education programs for internal and external clients.
• Develops and fosters effective internal and external strategic relationships through effective and timely communication.
• Synthesizes and organizes data, presents information, and provides executive summary of material.
• Supports the production of standardized coding training and related educational content for internal and external clients. Such content is to be created using industry-standard references and at all times complies with official published guidance per current regulatory / legislative recommendation.
• Delivers provider training and education in a variety of formats based on client need and internal initiatives. Such formats may include classroom-style education, webinar, audio-conferences or written content.
• Regularly interacts with providers and clinical/administrative staff to enhance understanding of Clinical Documentation Improvement program goals in order to achieve Risk Adjustment strategic goals and initiatives.
• Collaborates with internal teams to assure client / project-specific goals are met.
• Maintains accountability for outstanding customer service to all external and internal customers including timely responses.
• Performs other duties as assigned.

Skills

Risk Adjustment

Healthcare Knowledge

Educational Presentations

Data Analysis

Communication Skills

Microsoft Office

Stakeholder Relations

Education

Bachelor’s degree in health administration

Tools

Microsoft Office Suite

Job description

Your Future is our Future At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact.

Your Future is our Future At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact.

We're excited to consider every qualified candidate authorized to work in the United States, although we are unable to sponsor visas for this role at this time.

Position:

Principal RAS Partner & Educator

Position Summary:

Responsible for implementation of initiatives to improving coding and documentation accuracy for Lumeris clients. Acts as a subject matter expert and oversees the development and facilitation of the implementation of new and existing Risk Adjustment strategies at an advanced level. Provides support for short and long term strategy, program planning and implementation, patient campaigns, outreach tactics, educational programs, and develops and monitors key performance measurement activities. This position collaborates with internal teams to deliver standardized approaches to Clinical Documentation Improvement and Coding Education as a value-added benefit to Lumeris clients. This position will develop, create and provide disease-specific Risk Adjustment provider training that balances both clinical and coding/documentation focuses.

Job Description:

Primary Responsibilities

• Owns and manages a comprehensive Risk Adjustment strategy for our clients by developing effective risk adjustment operating plans and developing and implementing of education programs for internal and external clients.
• Develops and fosters effective internal and external strategic relationships through effective and timely communication.
• Synthesizes and organizes data, presents information, and provides executive summary of material.
• Supports the production of standardized coding training and related educational content for internal and external clients. Such content is to be created using industry-standard references and at all times complies with official published guidance per current regulatory / legislative recommendation.
• Delivers provider training and education in a variety of formats based on client need and internal initiatives. Such formats may include classroom-style education, webinar, audio-conferences or written content.
• Regularly interacts with providers and clinical/administrative staff to enhance understanding of Clinical Documentation Improvement program goals in order to achieve Risk Adjustment strategic goals and initiatives.
• Collaborates with internal teams to assure client / project-specific goals are met.
• Maintains accountability for outstanding customer service to all external and internal customers including timely responses.
• Performs other duties as assigned.

Qualifications

• Bachelor’s degree in health administration, business administration or related field or equivalent
• 8+ years of experience within Healthcare, Health plan, or Health System required, including payer, hospital, Medicaid/Medicare, provider environment or managed care or the knowledge, skills, and abilities to succeed in the role
• Knowledge of Risk Adjustment Payment methodologies and understanding of the CMS HCC, HHS, and Medicaid
• Excellent presentation skills, comfortably delivering educational presentations in large settings or 1:1, regardless of the format
• Track record of creating Coding Documentation Improvement (CDI) collateral, presentations and other educational tools
• Strong aptitude for critical thinking and data skills with the proven ability to identify, develop, communicate, implement, and impact process improvements and strategic initiatives
• Proven ability to create results, prioritize workload, and respond to changing demands/timelines in a dynamic environment
• Proficiency in Microsoft Office Programs including Word, PowerPoint, Excel, and Outlook
• Excellent interpersonal and communication skills with the ability to collaborate and work through all professional levels, internally and externally

Working Conditions

• While performing the duties of this job, the employee works in normal office working conditions.

Pay Transparency:

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements.

The hiring range for this position is:

$98,400.00-$132,225.00

Benefits of working at Lumeris

• Medical, Vision and Dental Plans
• Tax-Advantage Savings Accounts (FSA & HSA)
• Life Insurance and Disability Insurance
• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
• Employee Assistance Program
• 401k with company match
• Employee Resource Groups
• Employee Discount Program
• Learning and Development Opportunities
• And much more...

Be part of a team that is changing healthcare!

Member Facing Position:

No- Not Member or Patient Facing Position

Drug Screen Requirement:

No

MVR Required:

No

Credit Check Required:

No

Location:

Remote, USA

Time Type:

Full time

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.

Disclaimer:

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.