UCHealth Medical Risk Operations Manager Population Health in Denver, Colorado
Medical Risk Operations Manager – Population Health
This is a full-time (40 hrs/wk), exempt, salary position on UCHealth’s Clinically Integrated Network Finance and Analytics team based at the University of Colorado Hospital on the Anschutz Medical Campus in Aurora CO.
This position's pay range starts at: $33.82/hour.
The role of the Medical Risk Operations Manager is to develop and manage the Risk Coding Education Programs for UCHealth’s Clinically Integrated Network, Coordinated Care Colorado (“C3”). This new initiative will focus on creating revenue enhancement opportunities using existing data and current guidelines to create and support accurate risk adjustment coding, STARS quality improvement and medical cost reduction for C3. In addition, this role will provide cost analysis and intervention recommendations to support C3’s cost and quality improvement efforts including program development and supporting educational events.
• Develops and manages the new C3 strategic Medical Risk Adjustment Program providing medical risk education and driving documentation improvement and coding specificity initiatives for the C3 primary care practices.
• Represents C3 with Medicare Advantage (MA) health plan partners at regular operations meetings.
• Analyzes cost and quality data for all MA products in order to both recommend new interventions and programs as well as evaluate implemented initiatives.
• Participates in the development of clinical and coding workflows and risk coding reporting available in C3’s data integration solutions powered by Epic.
• Creates education series that will train practice providers, billing and support staff, as well as internal staff, on Medical Risk Adjustment, HCC coding opportunities, and STARS quality opportunities.
• Bachelor’s degree in related field
• 3 years of relevant experience
• The American Academy of Professional Coders (AAPC) Certified Risk Adjustment Coder (CRC) certification
• Certified Professional Medical Auditor (CPMA) and/or AAPC Certified Instructor
• Experience with setting up practice level processes in support of medical risk coding and documentation
• Experience with cost and data analysis to identify areas of opportunity for improvement and implementation of programs to support
• Experience with developing and administering education programs to a wide audience on medical risk coding and documentation
• Experience with several EHR systems; preferably Epic, Athena, and eCW
• Practice management / clinical background
• Strong knowledge of CMS coding guidelines
• Strong understanding of HEDIS/Medicare STARS quality measures
• Knowledge of health insurance claims practice and compliance
• Ability to lead individuals and teams in process improvement
• Exceptional interpersonal, public speaking, and presentation skills. Clear and confident communicator internally and with members/external partners
• Ability to travel within the state of Colorado
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UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an affirmative action/equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual’s race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status. UCHealth does not discriminate against any “qualified applicant with a disability” as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.