What are the responsibilities and job description for the Program Manager - Coding and Documentation position at U.S. Medical Management?
Program Manager - Coding and Documentation
U.S. Medical Management (USMM) is one of the nation’s largest home-based primary care practices. USMM is a family of companies all dedicated to providing high-quality, coordinated health care in the home. This includes Visiting Physicians Association (VPA), Pinnacle Senior Care, Grace Hospice, Comfort Hospice, The Home DME and In-Home Health Assessments (IHA).
Our Mission – “Through Compassionate Patient-Centered Care in the Home; We will Provide Exceptional Outcomes across our Continuum of Services”
Our Values – Respect, Integrity, Teamwork and Excellence - are leading us to a better tomorrow for patient care.
Why You Should Want to Work with Us
- Health, Dental, Vision, Disability & Life Insurance, and much more
- 401K Retirement Plan (with company match)
- Tuition, Professional License and Certification Reimbursement
- Paid Time Off, Holidays and Volunteer Time
- Paid Orientation and Training
- Great Place to Work Certified
- Established in 11 states
- Largest home-based primary care practice in the US for over 28 years, making a huge impact in healthcare today!
Position Description
The Program Manager – Coding and Documentation will work cross functionally with the management team to lead prioritization, definition, and strategies critical to success. The Program Manager–Coding and Documentation will lead key initiatives and implement action plans to achieve financial objectives and deep dive with business partners to align on qualitative and quantitative objectives.
Essential Duties and responsibilities
- Leads program development of Risk Adjustment initiatives for performance improvement
- Collaborates with other leaders to establish new and improved processes that enable Risk Adjustment to support health plan operations
- Provides project management support as needed such as ongoing support of applications, data interoperability, and data analytics
- Regularly reports project progress to key stakeholders through an established governance process
- Prepares routine reporting as needed for meetings with management
- Interprets data and be able to explain its impacts and need action items
- Acts as a subject matter expert on Risk Adjustment
- Supports business case development related to proposed projects
- Other duties and responsibilities as assigned
REQUIRED Knowledge, Skills and Experience
- Associates degree in healthcare, business, or related field
- Four or more years of experience in Risk Adjustment, preferable Medicare Advantage and Traditional Medicare
- Two or more years of experience with office management (PCP or specialist)
- Extensive knowledge of CPT, ICD-10-CM, CMS-HCCs, E&M coding principles and guidelines
- Possess a general working knowledge in internal integrity requirements and procedures
- Strong financial/business modeling, mathematics and analysis skills
Preferred Knowledge, Skills and Experience
- Bachelor’s’ degree in healthcare, business, or related field
- Strong financial/business modeling, mathematics and analysis skills
- Adept to working well within a fast pace environment
- Ability to manage multiple, complex projects and delivering on project objectives required
- Excellent problem solving skills
- Ability to work independent
- Ability to interpret reports and provide guidance on studies and government regulations and guidelines related to Coding
- Adept to working well within a fast pace environment
- Excellent written and verbal communication skills and demonstrated ability to develop effective lines of communication with all levels of staff
- Strong communication, time management and organization skills
- Self-motivated and results driven
- Exceptional collaborator that works well cross-functionally and with many competing priorities
Won’t you join us? We are seeking candidates who desire the opportunity and experience of delivering quality and compassionate healthcare - within proven care models – to elderly individuals and those with complex medical issues, who are the forefront of everything we do.
