[Hiring] Principal RAS Partner & Educator @Lumeris

Role Description

Responsible for implementation of initiatives to improving coding and documentation accuracy for Lumeris clients. Acts as a subject matter expert and oversees the development and facilitation of the implementation of new and existing Risk Adjustment strategies at an advanced level. Provides support for short and long term strategy, program planning and implementation, patient campaigns, outreach tactics, educational programs, and develops and monitors key performance measurement activities. This position collaborates with internal teams to deliver standardized approaches to Clinical Documentation Improvement and Coding Education as a value-added benefit to Lumeris clients. This position will develop, create and provide disease-specific Risk Adjustment provider training that balances both clinical and coding/documentation focuses.

Qualifications

• Bachelor’s degree in health administration, business administration or related field or equivalent
• 8+ years of experience within Healthcare, Health plan, or Health System required, including payer, hospital, Medicaid/Medicare, provider environment or managed care or the knowledge, skills, and abilities to succeed in the role
• Knowledge of Risk Adjustment Payment methodologies and understanding of the CMS HCC, HHS, and Medicaid
• Excellent presentation skills, comfortably delivering educational presentations in large settings or 1:1, regardless of the format
• Track record of creating Coding Documentation Improvement (CDI) collateral, presentations and other educational tools
• Strong aptitude for critical thinking and data skills with the proven ability to identify, develop, communicate, implement, and impact process improvements and strategic initiatives
• Proven ability to create results, prioritize workload, and respond to changing demands/timelines in a dynamic environment
• Proficiency in Microsoft Office Programs including Word, PowerPoint, Excel, and Outlook
• Excellent interpersonal and communication skills with the ability to collaborate and work through all professional levels, internally and externally

Requirements

• Owns and manages a comprehensive Risk Adjustment strategy for our clients by developing effective risk adjustment operating plans and developing and implementing of education programs for internal and external clients.
• Develops and fosters effective internal and external strategic relationships through effective and timely communication.
• Synthesizes and organizes data, presents information, and provides executive summary of material.
• Supports the production of standardized coding training and related educational content for internal and external clients. Such content is to be created using industry-standard references and at all times complies with official published guidance per current regulatory / legislative recommendation.
• Delivers provider training and education in a variety of formats based on client need and internal initiatives. Such formats may include classroom-style education, webinar, audio-conferences or written content.
• Regularly interacts with providers and clinical/administrative staff to enhance understanding of Clinical Documentation Improvement program goals in order to achieve Risk Adjustment strategic goals and initiatives.
• Collaborates with internal teams to assure client/project-specific goals are met.
• Maintains accountability for outstanding customer service to all external and internal customers including timely responses.
• Performs other duties as assigned.

Benefits

• Medical, Vision and Dental Plans
• Tax-Advantage Savings Accounts (FSA & HSA)
• Life Insurance and Disability Insurance
• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
• Employee Assistance Program
• 401k with company match
• Employee Resource Groups
• Employee Discount Program
• Learning and Development Opportunities
• And much more...