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Humana Senior Risk Adjustment Project Manager - Kansas City metro area in Overland Park, Kansas

Description

The Senior Risk Adjustment Project Manager manages the region's MRA Program, including upwards of 10 projects and initiatives. These projects range from internal and external operations to quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Senior Risk Adjustment Project Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

The Senior Risk Adjustment Project Manager l manages the region's MRA Program to execute its projects and initiatives to ultimately ensure coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records. May participate in provider education programs on coding compliance. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Required Qualifications

  • Bachelor's degree

  • Proficiency in all Microsoft Office Programs including Word, PowerPoint, advanced proficiency with Excel

  • Knowledge of ICD-10 and CPT coding

  • Good project management skills with the ability to matrix manage colleagues and projects

  • Strong written and verbal communication skills; strong analytical, organizational and time management skills

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

  • Master's Degree in Business Administration or a related field

  • Proficient with Access

  • Project Management certifications

  • Experience working in health service industry

  • CPC (Certified Professional Coder) Certification

Additional Information

Scheduled Weekly Hours

40

About Us

Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

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