Marshfield Clinic Health System · 9 hours ago
Risk Adjustment Revenue Manager (Remote)
United States
Full-time
Remote
Senior Level
5+ years expMarshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. The Risk Adjustment Revenue Manager is responsible for risk adjustment strategy and related revenue management for Security Health Plan’s Medicare, Affordable Care Act and Medicaid business, including program development, auditing processes, and collaboration with executives.
Health CareMedicalOncologyWellness
Responsibilities
Responsible for risk adjustment strategy and related revenue management for Security Health Plan’s Medicare, Affordable Care Act and Medicaid business
Provides development and implementation of programs and initiatives to improve the accuracy of the coding, including education; retrospective and prospective review processes; and vendor contract management
Accountability for preparation for and management of the Centers for Medicare and Medicaid Services (CMS) and the Department of Health Services (DHS) auditing processes
Management of encounter data processes; and management of applicable state and federal guidance
Works collaboratively with Security Health Plan executives and leadership as well as Marshfield Clinic Health System (MCHS) executives and leadership to lead risk adjustment strategy and process
Qualification
Required
Bachelor's Degree in Business Administration, Finance, Health Care Administration, Management or related field required
Five years of experience in risk adjustment or related area
Three years of experience in a management or leadership role and experience in the healthcare industry
Demonstrate a broad understanding of healthcare and health insurance
Demonstrate proficiency with verbal and written communication, strategic planning and business acumen
Certifications in professional coding and risk adjustment coding from American Academy of Professional Coders
State of Wisconsin driver's license with an acceptable driving record
Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid
Preferred
Post graduate degree(s) desirable
Working knowledge of CMS and/or Medicaid risk adjustment methodologies
None
Company
Marshfield Clinic Health System
Marshfield Clinic Health System provides neuro-oncology, maternal-fetal medicine, pediatric orthopedic surgery, and electrophysiology.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
unknown2024-10-23Acquired
Leadership Team
Adam Gingery
Director of Finance / Market CFO
Eric Pritzl
Director of Finance/Market Chief Financial Officer
Recent News
2024-04-08
Company data provided by crunchbase