Remote Risk Adjustment Manager — Data & Provider Programs

Astrana Health; California (MO); On-site; USD 102,000 - 115,000; Full time

Job summary

A healthcare organization is seeking a Manager - Risk Adjustment to lead risk adjustment initiatives, ensuring accurate documentation and compliance within the healthcare framework. You will oversee operations, coordinate with medical providers, and manage incentive programs. The role requires a Bachelor's degree, relevant certifications, and significant experience in risk adjustment and project management. A competitive salary between $102,000 - $115,000 is offered, alongside remote work flexibility with minimal travel to corporate offices in California.

Qualifications

• Bachelor's Degree required.
• Current AAPC or AHIMA certification required.
• 5 years' experience in risk adjustment or healthcare project management.
• 5 years in a managerial or supervisory role.
• Strong computer skills and proficiency in Microsoft Office.

Responsibilities

• Oversee daily operations of coding and specialists' teams.
• Collaborate with providers to implement risk adjustment processes.
• Audit chart review outcomes and provider coding trends.
• Manage regional Provider Incentive and Member Incentive Programs.
• Ensure compliance with regulatory guidelines.

Skills

Risk adjustment strategy

Project management

Health plan guidelines

Communication skills

Data analysis

Education

Bachelor’s Degree

AAPC or AHIMA certification

Tools

Microsoft Office Suite

Job description

A healthcare organization is seeking a Manager - Risk Adjustment to lead risk adjustment initiatives, ensuring accurate documentation and compliance within the healthcare framework. You will oversee operations, coordinate with medical providers, and manage incentive programs. The role requires a Bachelor's degree, relevant certifications, and significant experience in risk adjustment and project management. A competitive salary between $102,000 - $115,000 is offered, alongside remote work flexibility with minimal travel to corporate offices in California.