Job Description Summary

‎ 

Summary
Under the direction of the Sr. Manager, Risk Adjustment, the Burden of Illness Education Supervisor is responsible for providing first-line supervision for the Burden of Illness team of educators. Supervisor responsibilities include but are not limited to: daily supervision and monitoring of quality and productivity performance, interviewing, hiring, and any necessary discipline of staff. This position also involves participation in process improvement projects and supporting the work needed to meet department and organizational wide goals.

The position will oversee and coordinate all aspects of provider and medical staff education provided by each respective regional educator. S/he will plan, implement, and evaluate HCC education through a variety of mediums including direct, interactive learning sessions individually or in group settings, written guides and protocols, audits, etc. S/he will monitor various audits and reports to determine areas for improvement and ensure each region receives the assistance and direction deemed appropriate. S/he will communicate with department and site management ensuring that all providers and staff are performing to Millennium’s standards and fulfilling established goals.

The position requires a high degree of collaboration with Medical Directors, Value-Based Operational Leadership, and other members of the Burden of Illness department such as concurrent and retrospective coding audit teams and Quality Assurance teams to support shared initiatives.

Essential Duties and Responsibilities
• Provides daily supervision of education staff and provides feedback to the Sr. Manager, Risk Adjustment on exceptional and/or substandard performance.
• Leads all efforts associated with hiring, interviewing, onboarding and discipline of staff.
• Provides ongoing feedback to staff on areas of success and improvement opportunities.
• Ensures that all members of the team are following official guidelines, policies, and standard procedures.
• Counsels staff on actions required to meet minimum performance requirements.
• Provides or arranges for necessary knowledge-based resources required by the staff to meet quality standards.
• Prepares staffing schedules to provide adequate coverage for all bodies of work.
• Monitors upcoming, in-progress, and completed provider education based on completed audits, new provider onboarding, and other departmental metrics regarding provider support through education.
• Plans, develops, and designs HCC education and training programs among education team to ensure continuity of education. This includes preparation, facilitation, and follow-up.
• Evaluates education visit notes; performs research on relevant topics and develop and/or revises curriculum modules and/or presentation materials as appropriate.
• Coordinates with the MRA Managers to ensure organizational, departmental, and individual benchmarks are met.
• Coordinates with direct reports to ensure appropriate education is identified for providers and internal teams
• Provides clear, concise, and professional communication to varying audiences depending on the project and its goals.
• Executes process improvement projects.
• Stays current on applicable coding and documentation guideline changes and rules.
• Serves as a point of contact in area of expertise of Risk Adjustment; refers providers to other support services, such as Coding/Billing, IT, Learning & Development, as appropriate.
• Supports the MRA department in a positive manner with emphasis on delivering excellent service to all patients, providers, internal and external customers.
• Adaptable to shifting priorities and demonstrates willingness to do what it takes to meet department needs.
• Understands and complies with policies and procedures for confidentiality of all patient records, HIPAA, and security of systems.
• Demonstrates excellent time management, attends and participates in required meetings including hours outside of standard business hours and/or above a 40-hour week.
• Promotes Millennium Physician Group’s values.
• Perform other job-related duties as may be assigned or required.

Education and/or Experience
Required Minimum Education/Experience:
• High school diploma or GED equivalent
• Minimum 3 years’ experience working in payor or healthcare provider organization, specifically with roles in value-based care/risk adjustment
• Minimum 1 year experience in a lead/senior role
• Certified Risk Adjustment Coder (CRC)
o Additional acceptable credentials include: Certified Professional Coder (CPC) or other AAPC or AHIMA approved coding credential
Preferred Education/Experience
• 5+ years of experience working in healthcare provider organization, specifically with roles in value-based care/risk adjustment
• 3+ years experience presenting/educating healthcare professionals

Required Skills and Abilities
• Strong communication skills; able to interact with physicians and other clinicians on a professional level
• In-depth knowledge of ICD-10-CM diagnostic coding in the Medicare Risk Adjustment environment
• In-depth knowledge of NCQA technical specifications, value sets, and clinical standards of care
• Strong provider organization root cause analysis of provider office workflows and processes
• Must have excellent time management skills, be highly organized, self-motivated
• Excellent customer service, problem solving skills and attention to detail
• The ability to follow through timely on tasks is essential
• Possess excellent written, verbal, and interpersonal communication skills
• Must possess initiative; tact; poise; neat personal appearance; physical condition commensurate with the requirements of the position
• Project management of multiple initiatives with the ability to prioritize and meet deadlines.

Supervisory Responsibilities
Directly supervises assigned employees in the MRA department. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

‎ 

How will you make an impact & Requirements

‎ 

Summary

Under the direction of the Sr. Manager, Risk Adjustment, the Burden of Illness Education Supervisor is responsible for providing first-line supervision for the Burden of Illness team of educators. Supervisor responsibilities include but are not limited to: daily supervision and monitoring of quality and productivity performance, interviewing, hiring, and any necessary discipline of staff. This position also involves participation in process improvement projects and supporting the work needed to meet department and organizational wide goals.

The position will oversee and coordinate all aspects of provider and medical staff education provided by each respective regional educator.  S/he will plan, implement, and evaluate HCC education through a variety of mediums including direct, interactive learning sessions individually or in group settings, written guides and protocols, audits, etc.  S/he will monitor various audits and reports to determine areas for improvement and ensure each region receives the assistance and direction deemed appropriate. S/he will communicate with department and site management ensuring that all providers and staff are performing to Millennium’s standards and fulfilling established goals.

The position requires a high degree of collaboration with Medical Directors, Value-Based Operational Leadership, and other members of the Burden of Illness department such as concurrent and retrospective coding audit teams and Quality Assurance teams to support shared initiatives.

Essential Duties and Responsibilities

• Provides daily supervision of education staff and provides feedback to the Sr. Manager, Risk Adjustment on exceptional and/or substandard performance.
• Leads all efforts associated with hiring, interviewing, onboarding and discipline of staff.
• Provides ongoing feedback to staff on areas of success and improvement opportunities.
• Ensures that all members of the team are following official guidelines, policies, and standard procedures.
• Counsels staff on actions required to meet minimum performance requirements.
• Provides or arranges for necessary knowledge-based resources required by the staff to meet quality standards.
• Prepares staffing schedules to provide adequate coverage for all bodies of work.
• Monitors upcoming, in-progress, and completed provider education based on completed audits, new provider onboarding, and other departmental metrics regarding provider support through education.
• Plans, develops, and designs HCC education and training programs among education team to ensure continuity of education.  This includes preparation, facilitation, and follow-up.
• Evaluates education visit notes; performs research on relevant topics and develop and/or revises curriculum modules and/or presentation materials as appropriate.
• Coordinates with the MRA Managers to ensure organizational, departmental, and individual benchmarks are met.
• Coordinates with direct reports to ensure appropriate education is identified for providers and internal teams
• Provides clear, concise, and professional communication to varying audiences depending on the project and its goals.
• Executes process improvement projects.
• Stays current on applicable coding and documentation guideline changes and rules.
• Serves as a point of contact in area of expertise of Risk Adjustment; refers providers to other support services, such as Coding/Billing, IT, Learning & Development, as appropriate.
• Supports the MRA department in a positive manner with emphasis on delivering excellent service to all patients, providers, internal and external customers.
• Adaptable to shifting priorities and demonstrates willingness to do what it takes to meet department needs.
• Understands and complies with policies and procedures for confidentiality of all patient records, HIPAA, and security of systems.
• Demonstrates excellent time management, attends and participates in required meetings including hours outside of standard business hours and/or above a 40-hour week.
• Promotes Millennium Physician Group’s values.
• Perform other job-related duties as may be assigned or required.

Education and/or Experience

Required Minimum Education/Experience:

• High school diploma or GED equivalent
• Minimum 3 years’ experience working in payor or healthcare provider organization, specifically with roles in value-based care/risk adjustment
• Minimum 1 year experience in a lead/senior role
• Certified Risk Adjustment Coder (CRC)
  • Additional acceptable credentials include: Certified Professional Coder (CPC) or other AAPC or AHIMA approved coding credential

Preferred Education/Experience

• 5+ years of experience working in healthcare provider organization, specifically with roles in value-based care/risk adjustment
• 3+ years experience presenting/educating healthcare professionals

Required Skills and Abilities

• Strong communication skills; able to interact with physicians and other clinicians on a professional level
• In-depth knowledge of ICD-10-CM diagnostic coding in the Medicare Risk Adjustment environment
• In-depth knowledge of NCQA technical specifications, value sets, and clinical standards of care 
• Strong provider organization root cause analysis of provider office workflows and processes
• Must have excellent time management skills, be highly organized, self-motivated
• Excellent customer service, problem solving skills and attention to detail
• The ability to follow through timely on tasks is essential
• Possess excellent written, verbal, and interpersonal communication skills
• Must possess initiative; tact; poise; neat personal appearance; physical condition commensurate with the requirements of the position
• Project management of multiple initiatives with the ability to prioritize and meet deadlines.

Supervisory Responsibilities

Directly supervises assigned employees in the MRA department. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.