Risk Adjustment Manager - CoxHealth Plans
About The Position
This professional position is assigned the responsibility and accountability to manage and coordinate the risk adjustment programs for Cox HealthPlans (CHP). This manager will work with other staff and leaders within CHP to ensure risk-adjusted revenue matches members actual health status. Comprehensively understands financial side of risk adjustment models to analyze the program and provide meaningful analytics to leadership and others. From the financial knowledge obtained develops, designs and executes risk adjustment operational strategies and processes. Ensures compliance with all policies and risk adjustment regulations.
Requirements
- Bachelor’s degree in Accounting / Finance / Business
- At least 5 years of experience in accounting/finance, public health, health administration, health insurance or health related field.
- Attention to detail and self-starter
- Knowledge of governmental & other regulatory standards, requirements, & guidelines related to risk adjustment and compliance.
- Knowledge of personal computers and software.
- Knowledge of computerized programs.
- Ability to maintain accurate records.
- Ability to communicate effectively, both orally and in writing.
- Ability to establish and maintain effective and cooperative working relationships with staff and network providers.
- Ability to assume responsibility and exercise good judgment in making decisions within the scope of authority of the position.
- Ability to think and work effectively under pressure and accurately complete tasks within established times.
- Ability to prioritize tasks and meet deadlines.
- Ability to maintain confidentiality.
Nice To Haves
- Experience with risk adjustment program, government programs compliance, managed care.
- Previous supervisory experience preferred.
- Knowledge of principles of statistics.
Responsibilities
- Manage and coordinate the risk adjustment programs for Cox HealthPlans (CHP).
- Work with other staff and leaders within CHP to ensure risk-adjusted revenue matches members actual health status.
- Analyze the program and provide meaningful analytics to leadership and others by comprehensively understanding the financial side of risk adjustment models.
- Develop, design, and execute risk adjustment operational strategies and processes based on financial knowledge.
- Ensure compliance with all policies and risk adjustment regulations.
Benefits
- Medical
- Vision
- Dental
- Retirement with Employer Match
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What This Job Offers
Job Type
Full-time
Career Level
Manager
