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Senior Manager MRA Coding

Company: P3 Health Group Management, LLC
Location: Henderson
Posted on: August 6, 2022

Job Description:

Location field must contain 'city, state' or a zip code to perform a radius search (e.g., Denver, CO or 46122 ). City and state must be separated by a comma followed by a space (e.g., Houston, TX )P3 Health Partners is committed to ensuring the health and safety of our team members, patients and communities we serve. As a part of this commitment, all candidates must receive their COVID-19 vaccine prior to joining the team. If you have any questions about our interview and hiring procedures, please contact PeopleServices@p3hp.org.People. Passion. Purpose.At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients. We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.We are looking for a Senior Manager of Medicare Risk Adjustment Coding to lead our National program for CMS HCC coding. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing national organization based in Las Vegas, Nevada, then consider joining our team!Overall PurposeThis role will lead the design, management, and execution of the Coding Program for National Medicare Risk Adjustment, ensuring the organization achieves is target metrics and quality outcomes.The Senior Manager will provide operational leadership for P3 coding team.The Senior Coding Manager will serve as a process and subject matter expert and provide training and support to the clinical and operations staff and network partners as needed.The Senior Coding Manager of Medicare Risk Adjustment leads, manages, and mentors the staff members from the different teams such as CV coding, FFS coding and chart retrieval to support P3's achievement of deliverables on documentation completeness and accuracy, coding compliance and data collection, reporting and tracking for submission to health plans. Oversees risk adjustment coding initiatives for the organization, including medical chart retrieval, HCC risk adjustment data & documentation integrity, and supporting compliance programs. Leads implementation of programs designed to ensure all diagnosed codes and conditions are properly supported by appropriate documentation in patient chart. Programs include but are not limited to training and educational activities, CV programs, clinical chart review programs, retrospective reviews, submission, reconciliation, and electronic data submission.This person should possess the ability to interpret health care data into actionable information and identify analyses necessary to identify, track and understand emerging trends. This role will act as lead on MRA pilots and projects related to coding, documentation, CMS HCC code capture, historical conditions recapture and suspect conditions through the prospective and retrospective review. This role will indirectly lead the MRA activities within the markets we operate, working closely with the Market CMO, President and other key MRA and provider relations staff.Education and Experience:Bachelor's degree preferred. Successful completion of Coding Certificate program from an accredited organization (i.e. CPC, CRC, CPMA from AAPC, or CCS, CCS-P from AHIMA), with 3-5 years of professional coding experienceTwo years of Audit and/or Physician education experienceOne year of public speaking, talent development and/or training experienceDirect experience in understanding, implementing and coding of Medicare Risk Adjustment (HCC) guidance, documentation guidelines, compliance rules and regulations and Risk Adjustment Data Validation (RADV)Experienced with effective physician/provider collaborative training to support workflow adjustments to improve clinical coding qualityKnowledge, Skills and Abilities:Experience in health care insurance or health care industry requiredAssist in developing the MRA operational goals and metrics, in support of the organization's strategyManage, coach and develop MRA team members to be empowered experts in their fieldCollaborate with other organizational leaders to identify emerging needs and rally around solutions in provider engagementDevelop and maintain working relationships with Health Plans, Contracted Partners (Chart collection, Retrospective & Prospective Reviews, In Home Assessments) and external contacts as appropriate Identify and resolve issues that negatively impact the ability to deliver effective, high-quality health carePromote and market P3 population health management programs and services to clinicians and/or office staffEnsure MRA team develops documents maintains and updates policies and proceduresEnsure all deadlines and turnaround times set by department director are metAbility to work with multiple internal partners at various levels of the organizationWorking knowledge in general management tools include Microsoft Office products (Excel, Word, PPT, Outlook)Must possess strong project management skills, solid problem-solving, planning, communication, documentation, and organizational skills with meticulous attention to detailAbility to manage multiple tasks and projects, and forge strong interpersonal relationships within the department, with other departments, and with external audiencesAttention to detail is critical to the success of this position, with demonstrated competency in customer orientation and the ability to deal with ambiguityAbility to analyze, interpret and communicate recommendations to senior managementAbility to communicate clearly and effectively both orally and in writing requiredEssential Functions:Manage the MRA coding team including proactive team structure design and recruitment; outline team and individual goals; manage the execution of the goals; quality assurance reviews of team members; coach, mentor and develop the team members to be empowered to achieve the best and compliantEQUAL OPPORTUNITY EMPLOYERWe're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.DIVERSITY & INCLUSIONAt P3, we recognize and appreciate the importance of creating an environment in which all team members feel valued, included, and empowered to do their best work and bring great ideas to the tableEvery P3 family member's unique experiences, perspectives, and viewpoints are valued and support our ability to deliver the best possible experience for our patients, providers, payers, partners, and each other.

Keywords: P3 Health Group Management, LLC, Henderson , Senior Manager MRA Coding, Executive , Henderson, Nevada

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