Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
SCOPE OF ROLE
The NeueHealth Risk Adjustment Team is an integral component of Bright Health Group’s success as it defines and ensures outstanding clinical care for our members. As a Manager, Risk Adjustment Training, you will be responsible for the creation and delivery of education to providers and their staff, while assisting with the expansion of the NeueHealth innovative Risk Adjustment Education Program. You will serve as a primary resource for providers to address learning needs related to coding and documentation in the medical record and the various risk adjustment models of payment. This role will support the operational outreach of the NeueHealth Risk Adjustment Education Program, assisting with the design, development, and execution of program workplans by provider group. This role will work together with the other Risk Adjustment leaders in the team to support training efforts. The role works across departments, teams, project development offices, and lines of business to deliver best-in-class business results under strict regulatory adherence and compliance mindset.
The Manager, Risk Adjustment Training role major responsibilities include, but it is not limited to these items.
- Facilitate documentation and coding presentations to large and small groups of clinicians, practice managers, and certified coders via virtual and in-person delivery methods (including national travel when necessary)
- Cultivate effective partnerships in a matrix environment of coding educators, clinical, and market operations
- Assist Manager, Risk Adjustment Coding Education in development of education objectives and programs, including high-visibility training materials such as webinars, videos, education guides and guidelines to support the realization of NeueHealth’s Risk Adjustment Education Program being synonymous with the national standard for coding excellence
- Hires, trains, and develops a team of Risk Adjustment training staff, as appropriate
- Finds, communicates, and escalates root causes and ad hoc nuances with Care Partner clinical leadership
- Seeks, maintains, and assists with build of a best-in-class coding accuracy knowledge-base and independently finds opportunities to share with Care Partners
- Works with technology resources on reporting suite and data integration
- Follows, reports, and adheres to all regulatory guidance
- This position will have supervisory responsibilities for members of the Risk Adjustment team.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- Bachelor’s degree preferably in healthcare or technical related field or equivalent work experience required
- Five (5) or more years’ experience in Medicare Advantage and Commercial ACA risk adjustment coding required
- Current AAPC or AHIMA coding certification required
- Knowledge of Medicare Advantage, Commercial ACA, and related product and timing lifecycle required
- Proven focus and ability to communicate coding concepts in multiple settings
- Two (2) or more years’ experience in education and training required
- Advanced skills in Microsoft Office Products; Word, Excel, PowerPoint, Visio, SharePoint preferred
- Strong written and verbal communication skills
- Strong attention to detail
- Ability to quickly learn and adapt to meet business needs
- Experience working with multiple different learning platforms and delivery methods
- Demonstrated knowledge of risk adjustment regulations
- Ability to work independently
- Ability to build relationships with office staff, physicians, and market team
LICENSURES AND CERTIFICATIONS
- An active, unrestricted CPC, CRC, or similar designation is required for this role.
- The majority of work responsibilities are performed remotely, carrying out detailed work sitting at a desk/table and working on the computer.
- Some travel required.
We’re Making Healthcare Right. Together.
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.