Manager, Risk Adjustment Operations

Company:

AHI agilon health, inc.

Job Posting Location:

Austin

Job Title:

Manager, Risk Adjustment Operations

Job Description:

Position Summary:

The Manager of Risk Adjustment Operations will be accountable for successfully managing the Risk Adjustment program and overseeing the end-to-end execution of the program. Manages the Risk Adjustment teams and operations in their market and will work to ensure optimal provider engagement and provider performance in the market. This person will work across multiple operation teams to develop or improve systems, processes and tools that will help with the identification of diseases, assessment of the diseases and care gaps with proper documentation to ensure accurate submission of information to payer entities. The Manager of Risk Adjustment must also be adept with developing tactics to meet program goals and metrics.

Location:

This is a hybrid position meaning that the individual will split their time working remotely and from our Austin, TX office. Candidate must be located in the Austin, TX area.

Essential Job Functions:

• Responsible for team assignments, workload, and performance management

• Oversees the onboarding and training of Pre-visit Medical Record reviewers and monitoring metrics to determine program needs (i.e., clinical documentation education, auditing, etc.) and engages with Market or BOI Medical Director on next steps

• Participates in the orientation of other market team members by educating them to the BOI program

• Engages with Providers and their office staff on BOI. This includes sharing actionable data with them and driving performance

• Leads efforts to analyze markets performance data and operationalize efforts for improvement if identified

• Oversees the onboarding of any new providers or practices that join the market.

• Assist and support Risk Adjustment Director or designated Market Leader on projects as needed.

• Ability to travel between multiple locations

• All other duties as assigned

Other Job Functions:

• Understand, adhere to, and implement the Company's policies and procedures.

• Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded.

• Take personal responsibility for personal growth including acquiring new skills, knowledge, and information.

• Engage in excellent communication which includes listening attentively and speaking professionally.

• Set and complete challenging goals.

• Demonstrate attention to detail and accuracy in work product.

Qualifications:

Minimum Experience:

• 6+ years, of experience in managed care or the health care industry

• 1+ years managerial experience

• Experience with Program Management

• Must be able to interpret data

Education/Licensure:

• Bachelor's degree: or equivalent work experience required.

• Certified Coder preferred (CCS, CCS-P, CPC)

Location:

Austin