Risk Adjustment Manager - CoxHealth Plans

Job Summary

CoxHealth is seeking a professional to manage and coordinate risk adjustment programs for Cox Health Plans (CHP). This role requires a comprehensive understanding of financial aspects of risk adjustment models, and the ability to develop, design, and execute operational strategies and processes.

Responsibilities

• Work with other staff and leaders within CHP to ensure risk-adjusted revenue matches members' actual health status.
• Analyze the risk adjustment program and provide meaningful analytics to leadership and others.
• Develop, design, and execute risk adjustment operational strategies and processes.
• Ensure compliance with all policies and risk adjustment regulations.

Requirements

• Required: Bachelor’s degree in Accounting / Finance / Business.
• Required: At least 5 years of experience in accounting/finance, public health, health administration, health insurance, or health-related field.
• Preferred: Experience with risk adjustment programs, government programs compliance, and managed care.

Qualifications

• Comprehensive understanding of financial side of risk adjustment models.
• Knowledge of governmental & other regulatory standards, requirements, & guidelines related to risk adjustment and compliance.
• Knowledge of personal computers and software.
• Knowledge of computerized programs.
• Knowledge of principles of statistics, preferred.
• Attention to detail and self-starter.
• Previous supervisory experience preferred.
• Ability to maintain accurate records.
• Ability to communicate effectively, both orally and in writing.
• Ability to establish and maintain effective and cooperative working relationships with staff and network providers.
• Ability to assume responsibility and exercise good judgment in making decisions within the scope of authority of the position.
• Ability to think and work effectively under pressure and accurately complete tasks within established times.
• Ability to prioritize tasks and meet deadlines.
• Ability to maintain confidentiality.

Benefits

Medical, Vision, Dental, Retirement with Employer Match and more (20+ hrs/week). For a comprehensive list of benefits, please click here: Benefits | CoxHealth.