OVERVIEW OF POSITION:
Support the planning and coordination of market initiatives and operational programs related to Medicare Risk Adjustment. Lead market initiatives and support teams engaged in patient outreach, documentation integrity, and clinician education and tools.
Consistently exhibits behavior and communication skills that demonstrate HealthCarePartners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
Project management of multiple programmatic initiatives and activities related to Medicare risk adjustment at the California Market level.
Oversee market patient engagement, outreach, provider education programs to facilitate comprehensive health assessment for Medicare Advantage patient population, and other managed or risk-based populations.
Defines, implements, leads and measures processes from start to finish.
Ensures project deliverables, metrics measurement, and success criteria achieved.
Organize and provide executive, management and front-line initiatives and performance reporting and communication. Prepares timely and accurate monthly and annual reporting as required.
Partners with National and Market teams to select and manage vendors for programs such as health assessments, medical chart retrieval, and medical coding.
Coordinates implementation of programs designed to ensure all diagnosed codes and conditions are properly supported by appropriate documentation in patient charts.
Develops program strategic messaging and communication plans in partnership with Directors and others for each initiative.
Participates in the development and creation of program training materials (e.g., job aids, presentations, etc.).
Delivers training to various teammates and other stakeholders with fluency and credibility, facilitating a necessary understanding of key objectives.
Assesses, responds and reacts to CMS and/or internal mandates to ensure compliance and programmatic success.
Synthesizes complex programs and clearly communicates them to a wide range of stakeholders.
Reviews CMS documents related to risk adjustment, synthesizes findings, and formulates recommendations.
Uncovers insights from analyses that can be leveraged strategically, clinically or operationally.
Attends internal team meetings and calls to ensure alignment around project objectives, deliverables, and timelines.
Performs additional responsibilities as assigned.
Bachelor's degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college.
Master’s degree preferred.
Over 3-5 years of program management and process improvement.
Over 5-7 years in a healthcare setting.
Over 1-3 years management experience.
Experience working with health plans or large physician group.
Knowledge of Medicare Advantage and population health activities.
KNOWLEDGE, SKILLS, ABILITIES:
Demonstrated success working in dynamic, fast-paced environment.
Demonstrated success leading projects from ideation to closure.
Excellent verbal and written communication skills.
Ability to effectively interface with teammates, clinicians, and management.