Manager Quality Education & Coding
Company: Community Health Plan of Washington
Location: Washington
Posted on: November 19, 2023
Job Description:
If you are a job seeker with a disability and require a
reasonable accommodation to apply for one of our jobs, you will
find the contact information to request the appropriate
accommodation by visiting the following page: Job Category: Quality
& Performance Management Community Health Plan of Washington is
an equal opportunity employer committed to a diverse and inclusive
workforce. All qualified applicants will receive consideration for
employment without regard to any actual or perceived protected
characteristic or other unlawful consideration.Our commitment is
to:
- Strive to a pply an equity lens to all our work.
- Become an anti-racist organization
- Create an equitable work environment.About the RoleResponsible
for the development of provider coding education and works with the
Clinic Partnership team to support community health center (CHC)
specific training and development plans for organizational
improvement.To be successful in this role, you:
- Possess a bachelor's degree in Health Administration, Health
Information, or closely related field or an equivalent combination
of education and highly relevant experience (required).
- Have a valid Registered Health Information Administrator (RHIA)
or Certified Professional Coder (CPC) (required).
- A valid state Driver's License (required). This position may
involve traveling on behalf of the Company. It is essential that a
current driver's license and an acceptable driving record is
maintained.
- Have (3) years managing medical record review and/or coding for
HEDIS, HCC or other like projects (required). -
- Have (6) years' experience as a supervisor (preferred)
- Possess experience and knowledge in educating providers and
care teams in a health care setting.
- Proficiency with computer business applications, and a working
knowledge of electronic medical record (EMR) software.
- Have proficiency and experience with Microsoft Office
products.
- Have prior experience in clinical, quality, coding, and billing
workflows pertinent to a community health center setting
required.Essential functions and Roles and Responsibilities:
- Direct leadership, management, coaching and development of the
Clinic Quality Advisors
- Coordinates and collaborates with the Quality Concerns team to
provide timely review of pending or open cases that need clinical
oversight.
- Develops CHC learning plans for risk adjustment coding
education and works with CHC leadership and staff for
implementation strategies and delivery targets.
- Implements and delivers CHC-specific coding education for
organizational improvement as defined by each participating CHC
partner.
- Coordinates planned work with the team and manages CHC
expectations for successful consulting and education projects with
participating CHCs.
- In conjunction with the department management staff,
collaborate on the continued development of the clinic partnership
curriculum and menu of available education services for providers
and staff.
- Other duties as assigned. Essential functions listed are not
necessarily exhaustive and may be revised by the employer, at its
sole discretion.Knowledge, Skills, and Abilities:
- Knowledge and experience in delivering education to health care
providers and staff.
- Applied understanding of principles of reimbursement based on
risk adjustment model(s) including CMS Hierarchical Condition
Categories (HCCs) and Chronic Illness and Disability Payment System
(CDPS).
- Advanced, applied knowledge of ICD-CM codes, coding conventions
and coding guidelines.
- Strong written, verbal and presentation skills; able to
communicate with and collaborate effectively with physicians and
allied health care providers.
- Strong analytical skills and the ability to interpret, evaluate
and formulate action plans based upon data.As part of our hiring
process, the following criteria must be met:
- Complete and successfully pass a criminal background
checkCriminal History: -includes review of criminal convictions and
probation. CHPW does not automatically or categorically exclude
persons with a criminal background from employment. The applicant's
criminal history will be reviewed on a case-by-case basis
considering the risk to the business, members, and/employees.
- Has not been sanctioned or excluded from participation in
federal or state healthcare programs by a federal or state law
enforcement, regulatory, or licensing agency
- Vaccination requirement (CHPW offers a process for medical or
religious exemptions)
- Candidates whose disabilities make them unable to meet these
requirements are considered fully qualified if they can perform the
essential functions of the job with reasonable
accommodation.Compensation and Benefits:The position is FLSA Exempt
and is not eligible for overtime. Based on market data, this
position grade is 69 and has a 10% annual incentive target based on
company, department, and individual performance goals.CHPW offers
the following benefits for Full and Part-time employees and their
dependents:
- Medical, Prescription, Dental, and Vision
- Telehealth app
- Flexible Spending Accounts, Health Savings Accounts
- Basic Life AD&D, Short and Long-Term Disability
- Voluntary Life, Critical Care, and Long-Term Care
Insurance
- 401(k) Retirement and generous employer match
- Employee Assistance Program and Mental Fitness app
- Financial Coaching, Identity Theft Protection
- Time off including PTO accrual starting at 17 days per
year
- 10 standard holidays, 2 floating holidays
- Compassion time off, jury duty Sensory/Physical/Mental
Requirements:Sensory*:
- Speaking, hearing, near vision, far vision, depth perception,
peripheral vision, touch, smell, and balance.Physical*:
- Extended periods of sitting, computer use, talking, and
possibly standingMental:Office environment Employees who frequently
work in front of computer monitors are at risk for environmental
exposure to low-grade radiation.Equal Opportunity
Employer/Protected Veterans/Individuals with DisabilitiesThe
contractor will not discharge or in any other manner discriminate
against employees or applicants because they have inquired about,
discussed, or disclosed their own pay or the pay of another
employee or applicant. However, employees who have access to the
compensation information of other employees or applicants as a part
of their essential job functions cannot disclose the pay of other
employees or applicants to individuals who do not otherwise have
access to compensation information, unless the disclosure is (a) in
response to a formal complaint or charge, (b) in furtherance of an
investigation, proceeding, hearing, or action, including an
investigation conducted by the employer, or (c) consistent with the
contractor's legal duty to furnish information. 41 CFR
60-1.35(c)
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Keywords: Community Health Plan of Washington, Washington DC , Manager Quality Education & Coding, Executive , Washington, DC
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