ColumbusRecruiter Since 2001
the smart solution for Columbus jobs

Regional Manager, Risk Adjustment

Company: Molina Healthcare
Location: Columbus
Posted on: January 12, 2021

Job Description:

Job Description Job Summary The Regional Manager of Risk Adjustment is responsible for managing a team of professionals to meet the needs of the Medicaid, Medicare, and Marketplace lines of business as it relates to risk adjustment. Knowledge/Skills/Abilities * Manages risk adjustment staff in Regions (East, West, Central)* Monitors and tracks progress on risk adjustment initiatives across the region* Coordinates with Corporate Risk Adjustment to develop work plan and goal alignment within the region* Ensures standardization across the region related to risk adjustment for all lines of business (Medicaid, Medicare, and Marketplace)* May establish state specific policies and procedures outside of the enterprise risk adjustment model* Analyzes regional reports and audit findings to track progress as it relates to goals and KPIs* Implements coaching and training plans* Escalate gaps in projects to Director or Senior Leadership* Responsible for assisting the Director with implementation and oversight of risk adjustment projects* Management of Medicaid retrospective medical record review processesJob Qualifications Required Education BS Degree in Finance, Healthcare Administration, Business Administration or Health Information Management or equivalent work experience Required License, Certification, Association * 3 years' experience working in Risk Adjustment in a healthcare environment* Proficiency with risk adjustment methodologies* Understanding of healthcare terminology (CPT, ICD-10)* Knowledge of coding, HCCs, risk adjustments concepts, medical record review project management, encounter data management, compliance audit concepts* Strong familiarity and experience with underserved populationsPreferred Experience * 3 - 5 years management experience* Experience with risk adjustment data validations or equivalent compliance audits* Prior experience with CMS risk adjustment projects preferred.Preferred License, Certification, Association CPHQ, RHIA, CPC, CRC or CCS To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Keywords: Molina Healthcare, Columbus , Regional Manager, Risk Adjustment, Executive , Columbus, Ohio

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


General Manager in Training - Retail
Description: Req ID: 177531Do you want to Fuel Your Career Do you have experience managing high volume operations in Retail, Restaurants, Travel Stop or Convenience, Big Box, Grocery, or Department Store Do you (more...)
Company: Loves Travel Stops & Country Store
Location: Bellville
Posted on: 01/21/2021

Store Manager
Description: Job SummaryAs a GetGo Crew Lead, you will exceed customer and Team Member needs and expectations by providing safe, efficient, accurate and pleasant shopping, purchasing and food services in addition (more...)
Company: Giant Eagle
Location: Columbus
Posted on: 01/21/2021

Heating, Ventilation, and Air Conditioning Manager
Description: We are seeking to fill a Territory Sales Manager position reporting to the Regional Sales Manager.--In this role, you will be responsible for managing and driving sales growth of a broad line of HVAC/R (more...)
Company: PrincetonOne
Location: Columbus
Posted on: 01/21/2021


Psychiatric Medical Director
Description: Psychiatric-Mental Health opening in Columbus, Ohio. This and other physician jobs brought to you by DocCafe.com Psychiatric
Company: FCSpsy
Location: Columbus
Posted on: 01/21/2021

General Manager in Training - Retail
Description: REQ ID: DO YOU WANT TO FUEL YOUR CAREER Do you have experience managing high volume operations in Retail, Restaurants, Travel Stop or Convenience, Big Box, Grocery, or Department Store Do you have a (more...)
Company: Loves Travel Stops & Country Store
Location: Upper Sandusky
Posted on: 01/21/2021

Case Manager - Permanent Supportive Housing Program
Description: Volunteers of America Ohio Indiana seeks energetic, self-motivated, dynamic professionals to join its expanding team. VOAOHIN is dedicated to helping those in need rebuild their lives and reach their (more...)
Company: Volunteers of America Ohio-Indiana
Location: Columbus
Posted on: 01/21/2021

Shift Manager
Description: SHIFT MANAGER br br What's on the menu: br DailyPay br Benefits - Medical, Dental, Paid Vacation, and 401 k br Opportunity to advance quickly- we will train you br Competitive pay and eligibility (more...)
Company: Pizza Hut
Location: Lancaster
Posted on: 01/21/2021

Assistant Restaurant Manager
Description: At Chuck E. Cheese, we build careers around great food, family and fun Our purpose and passion is to create the best place for kids and families to eat and play Ready to take your management career up (more...)
Company: Chuck E. Cheese
Location: Dublin
Posted on: 01/21/2021

Assistant Manager - Restaurant
Description: Req ID: 206648Do you want to Fuel Your Career Do you have experience in Quick Service, Fast Food, or Full Service Restaurant management Do you have a proven track record of successful restaurant operations, (more...)
Company: Loves Travel Stops & Country Store
Location: Circleville
Posted on: 01/21/2021

88N Transportation Management Coordinator
Description: As a Transportation Management Coordinator, you will utilize your organizational skills to schedule and coordinate transportation for personnel and equipment, ensuring cargo and Soldiers make it to their (more...)
Company: Army National Guard
Location: Kenova
Posted on: 01/21/2021

Log In or Create An Account

Get the latest Ohio jobs by following @recnetOH on Twitter!

Columbus RSS job feeds