Manager, Risk Adjustment Coding Support

Your Future Evolves Here

Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.

Join Evolent for the mission. Stay for the culture.

What You’ll Be Doing:

Manager, Coding Support Specialist

Evolent Care Partners is seeking a Risk Adjustment Coding Support Manager to be a core member of the Risk Adjustment Coding Support team. Evolent Care Partners’ mission is to partner directly with primary care organizations across the country to improve patient outcomes and reduce avoidable healthcare costs. We are a lean, nimble, fast-paced team looking for dedicated team members with a passion for improving healthcare.

Collaboration Opportunities:

Our Risk Adjustment coding support team offers candidates the opportunity to make a meaningful impact by providing support to our providers, practices, and peers. The team values collaboration, continuous learning, and a patient-centric approach, ensuring every team member contributes to providing better health outcomes for the population. The Risk Adjustment Coding Manager plays a crucial role in ensuring accurate medical coding and compliance with risk adjustment models.

What You will Be Doing:

• Hires and oversees the initial orientation and development of Risk Adjustment coding team members, including coding support specialists.

• Provides leadership, management, and ongoing training to Risk Adjustment coding support team members, including monitoring performance toward achievement of OKRs and assigned initiatives.

• Conducts monthly chart and phone audits for individual team members, providing feedback and direction as appropriate.

• Responsible for ongoing performance management of assigned direct reports.

• Serves as a key member of the Risk Adjustment leadership team, assisting with annual refinement, revision, and expansion of OKRs for the Risk Adjustment coding support team.

• Use data to identify areas of improvement for individual employees and that impact the team. Provide individual and team training on clinical documentation requirements, risk adjustment coding guidelines, and updates.

• Oversee and manage day-to-day risk adjustment coding team and operations, ensuring accurate and timely ICD-10 coding of claims via progress note clinical documentation review.

• Ensure compliance and quality for all coding practices maintaining high standards and adherence with federal regulations to ensure cohesive and compliant coding per the AHA ICD-10 coding guidelines, AAPC and AHIMA and internal policies.

• Conduct regular audits and quality checks for coding staff and practices to mitigate risk and ensure correct coding and clinical documentation requirements.

• Develop and provide ongoing training and support to health care providers on clinical documentation requirements, risk adjustment coding guidelines, and updates.

• Data analysis and reporting by running internal reports to analyze coding data for the identification of trends, areas for improvement, and potential compliance risks with preparation of detailed reports and/or presentation for internal and external use.

• Regularly connect with coders to by serving as a resource to improve team dynamics and communication by problem solving and addressing regular coding questions and issues.

• Collaborate with the coding director to develop policies, procedures, and workflows to enhance department efficiency.

Qualifications – Required:

• A degree in health information, healthcare administration, or a related field or equivelent years of work experience.

• Certification in medical coding (CRC- Certified Risk Adjustment Coder) or demonstrated ability.

• 5+ years of experience in Risk Adjustment coding, with a focus on clinical documentation.

• Technical proficiency, strong knowledge of coding languages within multiple EMRs with familiarity of coding standards and best practice.

• Previous ma