Transform Healthcare as a Risk Adjustment Specialist II (Non-Clinical)

Join Our Mission to Improve Lives

We're seeking a highly skilled and motivated Risk Adjustment Specialist II to join our team at Workwarp, a subsidiary of Centene. As a key player in our organization, you will utilize your expertise in risk adjustment methodologies to drive provider performance and improve the health outcomes of our 28 million members.

Job Summary:

In this non-clinical role, you will leverage your knowledge of managed care organizations, ICD10 coding, and claims to develop strategies and best practices that enhance provider engagement and performance. Your expertise will focus on educating providers on risk adjustment coding and documentation competencies, analyzing data to identify trends and barriers, and collaborating with cross-functional teams to drive improvement initiatives.

Key Responsibilities:

• Develop and maintain collaborative relationships with 70-100 providers to educate and improve risk adjustment coding and documentation competencies
• Design and deliver training programs, materials, and resources to enhance provider and staff engagement in coding and documentation initiatives
• Analyze data and reports to identify risk adjustment trends, barriers, and opportunities for improvement, and develop strategies to address them
• Collaborate with internal stakeholders to develop newsletters, facilitate provider webinars and trainings, and promote best practices
• Apply clinical coding knowledge to review claims and medical records for accurate documentation and coding
• Provide expert guidance and support to providers on risk adjustment-related inquiries and barriers

Requirements:

• Bachelor's Degree in Health Promotion, Public Health, Health Administration, Business Administration, or a related field
• 3+ years of equivalent experience in Health Insurance, Customer Service, Claims, or Provider Office
• Knowledge of healthcare, managed care, and risk adjustment methodologies is highly preferred
• 20% in-state travel required (Arizona)

What We Offer:

• Competitive salary ($26.50 - $47.59 per hour)
• Comprehensive benefits package, including health insurance, 401K, and stock purchase plans
• Tuition reimbursement, paid time off, and holidays
• Flexible work arrangements, including remote, hybrid, field, or office work schedules
• Opportunities for professional growth and development

Join Our Diverse and Inclusive Team:

Centene is an equal opportunity employer committed to diversity, equity, and inclusion. We welcome applications from qualified candidates with diverse backgrounds, experiences, and perspectives. If you're passionate about transforming healthcare and making a difference in the lives of our members, apply today and let's build the future together!

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