
Risk Adjustment Coding Business Consultant - Remote
- Eden Prairie, MN
- $71,200-127,200 per year
- Permanent
- Full-time
- Serve as a coding subject matter expert for the business processes related to risk adjustment coding and audit operations
- Provide support and guidance on risk adjustment coding and clinical quality operations, accreditation, quality improvement initiatives
- Support root cause analysis and develop targeted interventions designed to improve clinical quality and risk adjustment outcomes
- Provide project management support for consulting engagements
- Provide consulting support for client engagements
- Assist in the development of written proposals and power point decks to support business development efforts
- Support business development/sales efforts by serving as a risk adjustment SME as part of client sales presentations and/or developing slide decks and written content to support RFP responses and client proposals
- Must have a current, active Certified Risk Adjustment Coder (CRC) Certification
- 3+ years of experience working as a Certified Risk Adjustment coder
- 3+ years of health plan experience
- Experience working multiple concurrent projects
- Experience working with external client requirements and meeting with clients on coding findings and operations
- Experience presenting findings and recommendations to internal stakeholders
- Ability to travel approximately 25% as business needs dictate
- Risk adjustment experience across product lines in addition to Medicare Advantage (i.e., Medicaid, ACA)
- Consulting experience
- End to end Risk Adjustment operations experience
- Proven Quality expertise (HEDISĀ®, NCQA Accreditation, Star Ratings)