Program Manager - Risk Adjustment & HCC

Required

• Education/Certification/Experience
• Experience: Minimum of 5 years of experience in the healthcare industry with a dedicated focus on risk adjustment coding optimization and HCC program management, including previous supervisory or team lead experience.
• Required Certifications: CRC (Certified Risk Adjustment Coder) through AAPC is strongly preferred. Note: If you do not currently hold a CRC, you must have a willingness to obtain it within an agreed-upon timeframe after hire.
• Preferred Additional Certifications: Active CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) credential.
• Knowledge: Deep understanding of CMS-HCC risk adjustment models, ICD-10-CM coding guidelines, and regulatory compliance requirements.
• Knowledge/Skills/Abilities
• Innovation & Strategy: A forward-thinking mindset with a proven track record of innovating processes and overcoming operational challenges.
• Collaboration & Leadership: Exceptional interpersonal and communication skills, with the ability to build trust, inspire a team, and work effectively across diverse departments (Clinical, RCM, Operations).
• Drive for Success: A highly motivated self-starter with a strong desire to succeed and achieve programmatic excellence.
• Patient-Centric Focus: An unwavering commitment to keeping quality and efficient patient care delivery at the heart of all business and operational decisions.
• Influence With & Without Authority: Exceptional interpersonal and communication skills with a proven ability to align diverse teams (providers, operational staff, IT, leadership) around shared goals with and without direct line authority.
• Matrixed Accountability: Comfort operating and accepting accountability within a highly collaborative, matrixed organizational structure.