Risk Adjustment Coordinator

POSITION SUMMARY:



The Risk Adjustment Coordinator performs a variety of administrative and staff support duties to support operations for the Risk Adjustment Team. This position resolves administrative problems and inquiries; composes, edits and proofreads correspondences and prepares a range of administrative documents and reports. Additional responsibilities include meeting support and answering/prioritizing communications and correspondence both internally and externally. Work involves the utilization of databases, complex spreadsheets, presentations and graphic materials.



ESSENTIAL DUTIES AND RESPONSIBILITIES



* Coordinates and performs a range of activities supporting the Risk Adjustment Team

* Responsible for organizing all provider reporting preparation, delivery and tracking

* Serves as a liaison with both internal and external customers on behalf of the Risk Adjustment team in the resolution of day-to-day administrative and operational problems

* Draft, proofread and finalize various documents, including letters, memos and reports, ensuring they conform to established procedures, and adhere to appropriate use of the English language, correct grammar, spelling and punctuation.

* Responsible for the support of provider office data collection process and periodic health plan data reports and requests

* Support Clinical Prospective Review programs with queue prioritization and distribution

* Support EMR and SFTP access for internal and external teams

* Edits, validates, and transmits outbound reports

* Maintains and updates files, databases, records, and/or other documents as necessary for assigned projects

* Assists management and staff in problem solving, project planning, and development and execution of stated goals and objectives

* Coordinates work plan development and maintenance with Network Engagement, Quality, and Education teams

* Supports deployment and training of new point of care tools

* Support team meetings, agenda, report preparation, manage minutes and distribution



KNOWLEDGE, SKILLS AND ABILITIES



* Working knowledge of health care delivery networks

* Intermediate proficiency in using Microsoft Office suite, including intermediate proficiency using Excel

* Knowledge of proper grammar, business and/or technical writing and medical terminology

* Highly developed skills in time management, organization and prioritization

* Effective problem-solving skills and ability to apply solutions that comply with internal, contractual and regulatory frameworks



* Ability to work in a tactful, diplomatic manner with internal and external customers and facilitate timely, efficient communication

* Ability to maintain confidentiality of patient and all related entity business matters of the organization and its partners

* Ability to identify and prioritize time sensitive matters and respond with a sense of urgency, as needed, while adapting to changes in workload demands

* Demonstrated ability to work independently

* Experience and ability multi-tasking in a fast-paced environment with multiple deadlines and changing priorities

* Demonstrated attention to detail

* Ability to read and understand English sufficiently to perform the duties of the position

* Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency, including a high level of proficiency with MS Office Suite



MINIMUM QUALIFICATIONS



EDUCATION: Associates Degree in Business Administration or Healthcare related field preferred. Experience in lieu of education will be considered.



EXPERIENCE:



* 3 years administrative experience with increasing level of responsibility

* 2 years working experience, within the last 5 years, with managed care products, Federal and State regulatory requirements (i.e., NCQA, HCFA, DOC), multiple health care delivery systems preferred