Manager of Medicare Advantage Coding, Education and Audit

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  JOB DUTIES
  

Take on an important leadership role within an award-winning health system. Help improve patient experiences as part of a world-class healthcare team. Take your career in an exciting new direction. You can do all this and more at UCLA Health. As a key leader within our Medicare Advantage team, you will develop and execute of strategies, programs, and projects while managing key performance indicators to drive operational excellence. You will be responsible for leading, developing, and facilitating the team to ensure the application of industry best practices related to accuracy, efficiency, and adherence to all regulatory and CMS compliance requirements. You will manage the coding consultants who provide audit, coding expertise, and provider education to internal and external clients. You will also serve as a Subject Matter Expert for Medicare Advantage risk adjustment. Note: Onsite with the consideration of flexible hybrid Salary offers are determined based on various factors including, but not limited to, qualifications, experience, and equity. The full salary range for this position is $78,800 – $175,000 Annually. The budgeted salary range that the University reasonably expects to pay for this position is about $115,000 – $140,000 Annually.

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  JOB QUALIFICATIONS
  

We’re seeking a self-motivated, flexible, goal-driven, service-oriented leader with: * This role will require occasional travel to local provider offices * Required Certified Professional Coder (CPC-I) certification, Certified Risk Adjustment (CRC) coder AAPC certification, and Certified Professional Medical Auditor (CPMA) certifications from AAPC (to obtain CPMA within 120 days from date of hire, if applicant does not currently possess) * Six or more years of risk adjustment experience * Three to five years of provider education experience with the development of educational materials and presentations * Five or more years of physician billing/coding experience * Previous managerial experience * Exceptional relationship-building skills with clinical and non-clinical personnel * Knowledge of the Medicare Advantage STARS program and NCQA technical specifications * In-depth understanding of HIPAA * Extensive knowledge of HCC models V24 and V28 * Familiarity with claims and encounter data processes * Experience conducting mock RADV or actual RADV * Related Bachelor’s degree and RN licensure preferred * Strong leadership, communication, prioritizing, and interpersonal skills * Ability to develop, implement, and evaluate methods and systems to improve efficiency * Expertise in leading cross-functional workgroups UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California. We’re also home to the world-class medical research and clinical education capabilities of the David Geffen School of Medicine. Through the efforts of our outstanding people, we have become Los Angeles’ trusted provider of exceptional, compassionate patient care. If you’re looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.