Risk Adjustment Coordinator (5702BR) Columbus, Ohio
• Works with Manager, Coding and Education and Manager, Vendor Oversight and CMS Submission to implement appropriate chart reviews and in-home assessments
• Removes barriers to access to provider records and / or barriers to contacting members
• Works with HP and Corp Reporting to monitor completed provider and member assessments to ensure Corporate goals are achieved within that HP
• Escalates problems promptly that would prevent Corporate goals from being achieved and recognizes the financial and compliance risk of not doing so
• May be asked to Upload HEDIS & RAMP files as directed by HEDIS & Risk Manager to File Net storage solution in a timely manner
• May be asked to Monitor and bring resolution to data mismatch and errors within FileNet
• Assists in current load of files as well as historical upload to FileNet
Bachelor's degree or equivalent work experience
• Minimum of 1 year experience in health plan quality improvement or equivalent experience
Preferred field: clinical, public health or healthcare
Some clinical training (ie LVN, EMT, LCSW, Medical Assistant)
To all current Molina employees if you are interested in applying for this position please apply through the intranet job listing. Also, fill out an Employee Transfer Request Form (ETR) and attach it to your profile when applying online.
Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.