TruHealth

The role involves contracting and credentialing providers and vendors to maintain CMS adequacy and network coverage. It also requires educating providers on Health Plan functions and maintaining positive professional relationships.

Provide personalized, coordinated healthcare to seniors in long-term care facilities to improve quality of life and prevent hospitalizations. Responsibilities include assessing medical needs, prescribing medications, and collaborating with integrated care teams.

Conduct coding audits and post-payment reviews to ensure accuracy and completeness of diagnosis codes for Medicare Risk Adjustment. Provide coding education to providers and develop metrics to improve documentation quality and minimize organizational risk.