Job Location : all cities,PA, USA
Are you an experienced Clinical Quality Management Analyst with a desire to excel? If so, then Talent Software Services may have a job for you! Our client is seeking an experienced Clinical Quality Management Analyst to work at their company 100% remotely.
Position Summary: This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs (MA and ACA), using skills including but not limited to: HCC Coding, medical coding, clinical terminology and anatomy/physiology, CMS coding guidelines, and RADV Audits. Works closely with physicians, team members, Quality, Compliance, partners at Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding. Supports all RPM risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC disease categories. Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement, provider education, analyzing reports, and identifying process improvements.
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