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Job Description Have you worked using Medical Terminology? Do you have Medical Coding or Medical Billing experience? If so, La Salle Medical Associates IPA (Maren) is searching for a highly qualified, engaging, team oriented and passionate professional who has experience with implementing Risk Adjustment strategies, training and education into the fabric of an organization, we invite you to consider joining our highly motivated team of professionals. This position serves as the subject matter expert for Risk Adjustment and will ensure the accurate, timely and compliant execution of all Risk Adjustment activities and achievement of related targets. The advocate will interact with all levels of internal and external management, employees, Health Plan Partners, Providers and their staff both in person and virtually. This position requires frequent travel within counties surrounding the Fresno area. This position should be well-versed in Risk Adjustment models for Medicare and familiar with Risk Adjustment modeling for Commercial. ESSENTIAL FUNCTIONS: Ensure Risk Adjustment is accurately captured Assist in generating amendments to encourage provider to conduct visits that improve Risk Adjustment Prioritize tasks and meet deadlines Ensure Risk Adjustment execution is efficient and consistent Set accountability by tracking progress, identifying and resolving issues, and collaborating with Health Plan/MSO partners utilizing tools and resources that are made available. Coordinate and facilitate meetings Complies with company policies and procedures and maintains confidentiality of member's medical information in accordance with state and federal laws Work with and support LaSalle’s Quality and Provider Services teams often with completing projects and priorities Support and perform general data validation as well as clarify and address questions to drive projects and performance Develop and distribute reports for senior leaders as it relates to risk adjustment metrics and performance Help develop strategies to implement enhancements and process improvements as necessary Maintain a positive and professional attitude Half of the day in the field working with Providers and clinic staff Perform other duties assigned Minimum Qualifications: Certification in either Coding, Billing, or Risk Adjustment Coding is preferred. Knowledge of risk adjustment requirements and their impact on the organization. Demonstrated independent and complex problem solving skills; including the ability to assist others in working through complex problems to meet desired outcomes. Must be comfortable in working with others to drive to best results and with working independently when working in the field Strong organizational skills, problem solving and decision making skills required. Demonstrated proficiency and experience with Microsoft Office products Ability to articulate and communicate effectively with effective verbal and written communication skills Ability to navigate through and utilize various PC applications efficiently. Ability to multi-task and deal with complex assignments on a frequent basis Demonstrated ability to be an effective, collaborative partner with internal staff and external partners. Experience in medical terminology, coding, and/or claims processing is helpful 1 year previous managed care experience strongly desired. Understanding of encounter and supplemental data collections, system processes, and regulatory data submissions for risk adjustment data management and methodologies for Medicare. Minimum two (2) years of health plan or health care experience, preferably with focus in healthcare analytics and risk adjustment models preferred. PLEASE NOTE; Candidates wishing consideration should also forward resumes directly to the hiring supervisor from Aug 15-Aug 26. Resumes should be sent to . Company DescriptionMaren Medical Group, DBA La Salle Medical Associates IPA is a healthcare organization dedicated to serving patients with affordable and compassionate patient care while working with State agencies to help manage patient costsMaren Medical Group, DBA La Salle Medical Associates IPA is a healthcare organization dedicated to serving patients with affordable and compassionate patient care while working with State agencies to help manage patient costs

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