Strategic Risk Adjustment & Quality Leader (HEDIS/Coding)

Jobtailor; Oregon (WI); On-site; USD 90,000 - 140,000; Full time

Benefits offered by this job

Health insurance

Job summary

Jobtailor is seeking a senior leader to oversee Risk Adjustment Coding and Quality/HEDIS programs in the U.S. The role requires expertise in risk adjustment, HEDIS, and healthcare management, with a strong track record in leading teams and implementing process improvements.

The position emphasizes compliance with coding guidelines and strategic management to drive improvements in healthcare operations. A managerial background and relevant certifications are essential for success in this role.

Qualifications

• Bachelor's Degree in Health-related field or current RN/LPN license.
• 6 years of combined experience with RN/LPN, Risk Adjustment, HCC coding, medical coding/billing HEDIS and/or healthcare related management.
• 3 years with government markets and working within all Compliance and Coding guidelines.
• 1 year in a management or leadership role.
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Registered Health Information Administrator (RHIA) or Clinical Research Coordinator (CRC)

Responsibilities

• Develop plans and manage activities in support of Risk Adjustment and Quality/HEDIS.
• Direct daily activities of direct reports supporting Risk Adjustment Coding and Quality/HEDIS.
• Assess viability of current direction/projects/operations and recommend strategies.
• Implement strategic and tactical improvements to Risk Adjustment Coding and Quality/HEDIS processes.
• Manage information to ensure accurate and efficient projects.

Skills

Risk Adjustment

HCC Coding

Healthcare Management

Compliance Guidelines

Strategic Planning

Project Management

Team Leadership

Communication

Strategic Thinking

Quality/HEDIS

Education

Bachelor's Degree in Health-related Field

RN/LPN License

Job description

Jobtailor is seeking a senior leader to oversee Risk Adjustment Coding and Quality/HEDIS programs in the U.S. The role requires expertise in risk adjustment, HEDIS, and healthcare management, with a strong track record in leading teams and implementing process improvements.

The position emphasizes compliance with coding guidelines and strategic management to drive improvements in healthcare operations. A managerial background and relevant certifications are essential for success in this role.