Manager, Risk Adjustment Operations - Remote

What We're Looking For:

The Manager, Risk Adjustment Operations is responsible for the oversight and management of coding production, quality, and vendor management. This role is responsible for ensuring adherence to departmental goals, quality standards, metrics, policies, etc. They will provide leadership and guidance regarding activity, status, trends, coaching/feedback methods and coordination of additional resources to support coding production and quality.

What You Will Do:

• Create and manage team's daily, weekly and monthly production and quality goals to ensure that department objectives are met.
• Cross functional collaboration to ensure that QA, trends and education is provided timely and accurately to team members.
• Maintain internal coding policies and procedures to ensure compliance, coding consistency and up to date coding practices.
• Oversee onboarding, staffing plans and staff performance to ensure optimal talent management and utilization.
• Effective team management and utilization to achieve coding operational KPI's.
• Accountability and mentoring of supervisors and staff to business values and coding operations KPI's
• Reporting to coding leadership on business trends and project coding patterns as well as an obstacles to achieving KPI's or deadline.
• Collaboration with the Training/Education Department with a focus on content development/design, training coordination and facilitation
• Manage all aspects of the Auditing and Quality Department for remote coding teams as well as field teams as necessary.
• Monitor and report effectiveness of training programs from research, benchmark, propose training and development opportunities to drive continuous improvement.
• Approve team member's PTO and manage staff's time out of office while continuing to meet department Auditing and Quality goals.
• Knowledge and expertise in use of NLP and AI technology in coding business.
• Collaboration with coding production to achieve 95% coding quality accuracy at project level.
• Accountability and mentoring of quality and audit supervisors and audit staff to business values and coding operations KPI's.
• Vendor oversight - performing production and quality oversight for both onshore and offshore vendors.
• Facilitate communication in regards to production and quality KPI metrics with vendors.
• Monthly reconciliation of vendor performance metrics to assist with billing and SLA penalties if applicable.
• Provide operational assistance to vendors regarding training, project assignment and system support.
• Business related travel up to 20%.

What You Need to Succeed:

• Bachelor's Degree or a minimum of five years of equivalent experience in quality and/or coding management role(s) with increasing level of responsibility.
• A minimum of 5 years of experience in risk adjustment coding and/or auditing experience.
• 3-5 years of people leadership experience
• Experience with adult learning methodologies and distance learning preferred
• Excellent written and oral communication skills.
• Strong managerial, leadership, and interpersonal skills.
• Outstanding organizational skills.
• Ability to communicate effectively with all levels of the organization.
• Ability to work effectively in a remote, team environment.
• Flexibility in work schedule to meet departmental needs.
• Strong analytical and problem-solving skills to grasp the key points from complicated details and provide direction/ coaching to members of the team.
• A strong knowledge base of medical terminology, medical abbreviations, pharmacology and disease processes.
• Ability to analyze data to determine the root cause of identified quality/production concerns.
• Must be able to follow instructions, meet deadlines and work independently.
• Intermediate Excel skills and the ability to use other Microsoft applications
• Working knowledge of the business use of computer hardware and software to ensure effectiveness and quality of the processing and security of the data.
• AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC, or CRC)

What We Offer:

• Comprehensive health, dental, and vision insurance
• Retirement savings plan
• Opportunities for career growth and development
• Employee wellness programs
• Additional benefits based on location and role