Risk Adjustment & HCC Program Lead

Hartford HealthCare; Hartford (CT); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Hartford HealthCare in Hartford, CT is seeking an experienced Risk Adjustment Program Team Lead to coordinate the Risk Adjustment team, verify coding reviews, and ensure reports are accurate. The role partners with the Director of Quality and Clinical Integration to improve workflows and drive network initiatives, aligning coding with CMS guidelines.

Requires 5+ years in Risk Adjustment/HCC, knowledge of Medicare Advantage, and leadership experience.

Qualifications

• Minimum: Associate's degree in a health-related field or equivalent work experience
• Preferred: Bachelor's Degree in a health-related field or equivalent work experience

Responsibilities

• Oversee complex ICD-10 and HCC coding and documentation training programs
• Implement training programs for network providers across settings
• Collaborate with clinical, operational, and financial leaders to optimize HCC workflows
• Review medical records to support documentation and clinical severity
• Develop training guides and standard work documents
• Maintain coding quality and productivity benchmarks
• Collaborate on retrospective and targeted medical record reviews
• Develop educational programming for providers and departments
• Stay up to date with HCC coding regulations and ensure compliance

Skills

Leadership

Communication

Project management

HCC knowledge

CMS regulations

Education

Associate's degree

Bachelor's degree (preferred)

Tools

MS Word

Excel

PowerPoint

Job description

Hartford HealthCare in Hartford, CT is seeking an experienced Risk Adjustment Program Team Lead to coordinate the Risk Adjustment team, verify coding reviews, and ensure reports are accurate. The role partners with the Director of Quality and Clinical Integration to improve workflows and drive network initiatives, aligning coding with CMS guidelines.

Requires 5+ years in Risk Adjustment/HCC, knowledge of Medicare Advantage, and leadership experience.