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A healthcare provider is seeking a Risk Score Accuracy Program Manager to lead initiatives in health population integration. This remote position involves overseeing diagnosis coding accuracy, supporting payer relationships, and ensuring compliance with coding regulations. The ideal candidate will have 5 years of experience in a healthcare system and a Bachelor's degree. Competitive pay and benefits are offered.
Thank you for considering a career at Bon Secours Mercy Health!
Scheduled Weekly Hours: 40
Work Shift: Days (United States of America)
Primary Function/General Purpose of Position
The Risk Score Accuracy (RSA) Program Manager provides leadership, oversight, coordination, and subject matter expertise for insights related to Population Health Clinical Integration RSA initiatives, including Hierarchical Condition Categories (HCC) coding and other risk adjustment payment models. This role strategizes and collaborates with key stakeholders across the Ministry, including Bon Secours Mercy Health (BSMH) Population Health, Compliance and Revenue Cycle teams, Ensemble, and BSMH physicians and advance care clinicians, to achieve system-wide success in value-based contracts.
This is a remote/work from home position. Hire must be open to working eastern time zone hours.
Certified Professional Coder (CPC) or equivalent, (preferred at time of hire, required within one year of hire)
Certified Risk Coder (or equivalent), Licensed Practical Nurse or other clinical certification (preferred)
Bachelor’s Degree (preferred)
5 years of experience progressive responsibility, with risk score accuracy or quality outcomes experience, with a payer or in a healthcare system (required)
Epic Electronic Health Record (preferred)
None
Not applicable to this position
Periods of high stress and fluctuating workloads may occur.
Long-distance or air travel as needed- not to exceed 10% travel.
General office environment.
Required to car travel to off-site locations, occasionally in adverse weather conditions.
Risk Score Accuracy
Program Management
Medical Terminology
CPT
Data Validation
Hierarchical Condition Categories
ICD-10-CM
Payer Relationships
Medical Coding
Data Collection
Analytical Skills
Trend Analysis
Communication
Communication with all levels
Collaboration
Attention to Detail
Process Improvement
Stakeholders
Managing Multiple Priorities
Time Management
Bon Secours Mercy Health is an equal opportunity employer.
As a Bon Secours Mercy Health associate, you’re part of a Mission that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.
Bon Secours Mercy Health is an equal opportunity employer. It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability.