Risk Adjustment Clinical Consultant

HealthPartners is hiring a Risk Adjustment Clinical Consultant. This position, in partnership with the risk adjustment and provider relations teams, is responsible for development, implementation, tracking, and reporting key risk adjustment clinical initiatives; working to ensure that plan performance is based on an accurate representation of our population's care needs and risks.

MINIMUM QUALIFICATIONS:

• Education, Experience or Equivalent Combination:
• Bachelor's degree in a related field or equivalent years of experience
• Minimum of five years experience working in a healthcare setting
• Minimum of five years experience managing projects and deliverables
• Working knowledge of the Medicare, Medicaid, and ACA risk adjustment models

• Licensure/ Registration/ Certification:
• One of the following medical coding certifications: CRC, RHIA, RHIT, CPC, CCS, CCS-P

• Knowledge, Skills, and Abilities:
• Skill and experience in effectively collaborating with team members & others using oral, written and interpersonal communications
• Organize and prioritize multiple assignments
• Ability to deal with change and ambiguity
• Able to work, both, as a team member or independently
• PC skills in Microsoft Word, Excel, PowerPoint, Visio, SharePoint

PREFERRED QUALIFICATIONS:

• Education, Experience or Equivalent Combination:
• Nursing or health sciences degree
• PMP certification
• Experience working with Epic and other EMR and risk adjustment solutions

ESSENTIAL DUTIES:

1. (35%) - Develops, implements, and delivers provider education materials. Accountable for developing a library of education materials, both internal and external content. Build and maintain an online portal for education materials.
2. (35%) - Develops and executes the education strategy and approach for provider partners, educates and influences with focus on diagnosis accuracy
3. (10%) - Develops and executes the education strategy and approach for internal leaders and employees. Educates and influences, which may include senior leaders in health plan, finance leaders, physicians, coders, etc.
4. (10%) - Supports chart retrieval, chart review, and audit activities
5. (10%) - Vendor management

*Job description rankings/percentages are intended to reflect normal averages over an extended period of time, and are subject to daily variances. Quality and efficiency standards should at no time be compromised to meet the average expectations expressed above. Job descriptions are subject to change to accommodate organization or department needs.

ORGANIZATIONAL EXPECTATIONS:

Values

All colleagues are expected to live our values:

Excellence: We strive for the best results and always look for ways to improve.

Compassion: We care and show empathy and respect for each person.

Partnership: We are strongest when we work together and with those we serve.

Integrity: We are open and honest, and we keep our commitments.

Additional Expectations:

• Complies with safety instructions, observe safe work practices, provides input on safety issues, and promotes a safe work environment.
• Maintains regular and timely attendance.
• Protects confidentiality.
• Demonstrates participation in and support of the organization's Corporate Integrity Program by participating in compliance-related education and training and complying with the organization's policies and procedures.
• Timely completion of all mandatory education and organizational requirements (i.e., licensure/certification, Employee Health and Wellness requirements, annual training, etc.)

POPULATION SPECIFIC COMPETENCIES:

Departments will need to determine the appropriate competencies in their areas for their specific patient populations documented in the essential duties section.

Examples of items that can be included are:

• Identifies expected outcomes for a plan individualized to the patient or situation specific to the needs of the population served.
• Communicates effectively with patients, families, and team members.
• Integrates practices that supports patient safety, acknowledges variations in populations served.
• Anticipates the needs of the population served as well as the unique characteristics of the communities served.
• Anticipates the needs of the population in providing culturally responsive care and develops an individualized plan for patients and families.

LEADERSHIP RESPONSIBILITY:

This role will influence and lead provider leaders, clinicians, and support staff to adopt efficient and effective workflows, as well as educate all applicable staff on documentation and coding needs to support complete and accurate diagnosis reporting.