[Remote] Risk Adjustment Revenue Manager (Remote)

Note: The job is a remote job and is open to candidates in USA. Marshfield 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. 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 Skills • 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 • Post graduate degree(s) desirable • Working knowledge of CMS and/or Medicaid risk adjustment methodologies • None Company Overview • Marshfield Clinic Health System provides neuro-oncology, maternal-fetal medicine, pediatric orthopedic surgery, and electrophysiology. It was founded in 1916, and is headquartered in Marshfield, Wisconsin, USA, with a workforce of 10001+ employees. Its website is https://www.marshfieldclinic.org. Apply tot his job Apply To this Job