Value Based Risk Coordinator

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NEW HAVEN, CT
Oct 25, 2019

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Job Description

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

The Risk Coordinator, under the direction of the Associate Director Value-based Programs, oversees all projects associated with documenting accurate coding, risk stratification reports, and supporting work to complete forms related to HCC (Hierarchical category Condition) coding improvement. Duties include coordination of short term and long term collaborative projects across YNHHS entities. Responsible for coordinating all activities associated with closing HCC gaps and risk stratification reporting by clinician and/or the group practice. Responsible for project management associated with the value team through the implementation of coding capture, risk adjustment, risk stratification and other projects that improve patient care, promote patient diagnosis to highest level of specificity, promote customer/vendor satisfaction and enhance revenue.

EEO/AA/Disability/Veteran

Responsibilities

  • 1. Monitors all risk adjustment and risk stratification project work plans and ensures that project milestones are met by pre-determined completion dates.
  • 2. Coordinates and manages special projects as needed, such as vendor evaluation and management and documentation-collaborative with HIM and outside vendors.
  • 3. Submitting data to payers and risk adjustment reports to Associate Director and Director Value Based Programs
  • 4. Ensures planning is appropriate and that planning will allow the team to successfully complete assigned deliverables on-time and to budget.
  • 5. Coordinate all project communication across NEMG departments, sites, and YNHHS entities.
  • 6. Anticipates issues and works with Associate Director and team to swiftly mitigate the impact of these issues on project plan.
  • 7. Identifies barriers that may prohibit meeting project timelines and communicate to Associate Director.
  • 8. Through coordination with Associate Director, will assist in running reports, analysis, and presentations to demonstrate results.
  • 9. Monitors risk project deliverables and reports status on a regular basis to Associate Director
  • 10. Interacts with external contacts such as payer representatives and outside vendors to coordinate activities, manage action plans, and distribute risk activity data as well as, financial information.
  • 11. Coordinates and tracks documentation associated with the HQPAF program, Vatica program, UHC MCAIP program and other similar programs.
  • 12. Direct oversight of nurses and light-duty nurses in the Value Team Hub: monitoring timecards, work completion, quality of work, completeness of returning information to vendors/insurers
  • 13. Ensures timely and accurate communication with office supervisors of clinicians participating in Risk adjustment/shared savings activities (whether form based programs or not) Includes sending forms from individual projects to correct NEMG sites
  • 14. Work with outside vendors who audit charts that are part of risk based programs. Must coordinate list of files that go to the reviewers/auditors to confirm the chart has adequate documentation.
  • 15. Read, organize, and update project spreadsheet.
  • 16. Follows all Standards of Professional Behavior when communicating with providers, colleagues, and business associates.
  • 17. Other duties and special projects as assigned.

Qualifications

EDUCATION


Bachelor?s degree in healthcare or business related field.


EXPERIENCE


Two to five (2-5) years of experience in a relevant healthcare setting. Project management experience and skills essential.


SPECIAL SKILLS


Ability to organize. Excellent verbal and written communication skills. Strong interpersonal skills ability to work effectively at all levels in a collaborative team environment. Knowledge and understanding of relevant clinical workflow, operating systems, policies and procedures as needed. Ability to effectively establish and maintain working relationships with peers, consultants, vendors at all levels of the organization. Knowledge of project management software tools as well as strong desktop tool usage including Word, Excel, PowerPoint, Adobe Acrobat/Reader.


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Job Info

Job: 13432

Department: Administrative Costs
Category: NON - CLINICAL OTHER
Sub Category: ADMIN PROF
Status: Full Time Benefits Eligible
Shift: D
Hours: 40

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