Manager, Risk Adjustment (ACO Operations)

 Published 8 days ago
 United States
Apply Now Please mention DailyRemote when applying

Disclaimer: Before you apply, please make sure the job is legit.

Attempting to apply for jobs might take you off this site to a different website not owned by us. Any consequence as a result for attempting to apply for jobs is strictly at your own risk and we assume no liability.

The NeueHealth Risk Adjustment Team is an integral component of NeueHealth’s success as it defines and ensures value-based care delivery and performance. As a Risk Adjustment ACO Operations Performance Manager, you will be responsible for the evaluation of NeueHealth’s Medicare ACO risk adjustment program performance and the creation and delivery of education to providers and their staff. You will serve as a primary resource for Medicare ACO partners to address learning needs related to coding and documentation in the medical record and the various risk adjustment models of payment. This role supports the operational outreach of the NeueHealth ACO Risk Adjustment Program, assisting with the design, development, and execution of program workplans by ACO partners. This role will work together with the other Risk Adjustment leaders in the team to support Risk Adjustment performance. The role works across departments, teams, project development offices, and lines of business to deliver best-in-class results under strict regulatory adherence and compliance mindset.

This is a work from home position.  Preferred locations for candidates are CA, MN, TX, FL


The major responsibilities for the Risk Adjustment ACO Operations Performance Manager role include, but not limited to these items.

  • Evaluate risk adjustment performance for multiple ACO clinical partners and identify opportunities and risk areas
  • Cultivate effective partnerships in a matrix environment of coding educators, clinical, and market operations
  • Implement risk adjustment program leading practices at partner practice locations
  • Facilitate documentation and coding presentations to large and small groups of clinicians, practice managers, and certified coders via virtual and in-person delivery methods (including national travel when necessary)
  • Develop and deliver Risk Adjustment education training materials such as webinars, videos, education guides and guidelines
  • Build and maintain a best-in-class coding accuracy knowledgebase
  • Follows, reports, and adheres to all regulatory guidance, including changes related to the Medicare risk adjustment methodology
  • Other duties and responsibilities as assigned.


•    Bachelor’s degree preferably in healthcare or technical related field or equivalent work experience required
•    Five (5) or more years’ experience in Medicare Advantage risk adjustment coding required
•    Current AAPC or AHIMA coding certification required
•    Experience analyzing risk adjustment performance and creating condition evaluation assessment key performance measures and developing risk adjustment program initiatives
•    Expertise in Medicare Advantage risk adjustment model and timing lifecycle required
•    Strong analytical skills in reviewing data used to determine Medicare Advantage risk scores
•    Proven focus and ability to communicate coding concepts in multiple settings
•    Experience in education and training required
•    Advanced skills in Microsoft Office Products; Word, Excel, PowerPoint, Visio, SharePoint preferred

•    Strong written and verbal communication skills
•    Strong attention to detail
•    Ability to quickly learn and adapt to meet business needs
•    Experience working with multiple different learning platforms and delivery methods
•    Demonstrated knowledge of risk adjustment regulations
•    Ability to work independently
•    Ability to build relationships with office staff, physicians, and market team

•    An active, unrestricted CPC, CRC, or similar designation is required

For individuals assigned to a location(s) in California, NeueHealth is required by law to include a reasonable estimate of the compensation range for this position. Actual compensation will vary based on the applicant’s education, experience, skills, and abilities, as well as internal equity. A reasonable estimate of the range is $92,000.00-$138,000.00 annually.

Additionally, employees are eligible for health benefits; life and disability benefits, a 401(k) savings plan with match; Paid Time Off, and paid holidays.

Ace Your Job Interview

Read our advice on how to answer the most common interview questions.