Risk adjustment coding manager

Company Description

Care Connectors is a value-based care enablement platform dedicated to assisting health plans and risk-bearing providers in managing prospective risk adjustment, quality improvement, and care coordination. By offering both in-person and virtual services for members and patients at home or in community settings such as primary care and mobile clinics, Care Connectors enhances healthcare delivery. The company specializes in engaging hard-to-reach and non-compliant patients, supporting primary care physicians and health plans in achieving improved outcomes. With a strong focus on adapting to regulatory and reimbursement changes, Care Connectors delivers impactful and patient-centered solutions.

Role Description

This is a full-time, remote role for a Risk Adjustment Coding Manager. The individual in this role will oversee risk adjustment coding operations, ensuring compliance with coding guidelines, reviewing and monitoring coding accuracy, and optimizing processes for accurate documentation. Responsibilities include managing and mentoring coding teams, analyzing performance metrics, collaborating with cross-functional teams, and implementing process improvements to meet organizational goals.

Qualifications

• Expertise in Risk Adjustment coding and guidelines, including HCC coding and ICD-10-CM coding.
• Strong skills in leadership and team management to guide and support coding staff effectively.
• Proficiency in quality monitoring, data accuracy, and compliance with regulatory requirements.
• Knowledge of healthcare operations, processes, and risk adjustment methodologies.
• Excellent written and verbal communication skills, with the ability to collaborate across teams.
• Ability to work independently in a remote environment and meet project deadlines efficiently.
• AHIMA or AAPC certification (e.g., CPC, CRC) is required.
• Experience in the healthcare industry, particularly with value-based care or managed care plans, is a plus.