RN Manager, Population Health & Clinical Coding

Company: Unity Health Network
Location: Cuyahoga Falls
Posted on: May 27, 2023

Job Description:

Summary of Position

Coordinates the development of operational framework focused on scalable and repeatable best practices as it relates to Risk Adjustment and Clinical Quality Metrics (HCC/RAF/HEDIS) . Works to identify and improve quality, risk, and affordability initiatives.

• This position identifies, develops and implements simplification and automation to improve HCC/RAF/HEDIS and other key performance initiatives.
• Coordinates performance improvement programs related to clinical coding as well as clinical and administrative workflows and business processes. Works with office staff and management to implement new processes and train staff on methodology.
• Oversees and works to grow population health initiatives and performance initiatives. Supports initiatives designed to reduce avoidable hospital visits, avoidable emergency room visits and readmissions.
• Ensures effective communication with physicians and staff members to enhance the success and support growth of each practice and attainment of quality and performance metrics.
• Monitors data, completes data analysis and conducts audits as indicated. Reports status of quality, risk, and affordability programs to appropriate team members, senior management and physicians. Requirements
  
  Education and Training
  • Graduate of an accredited school of nursing with a current State of Ohio nursing license, BSN preferred.
  • Certified Risk Adjustment Coder (CRC) certification or proof that certification has been obtained within 6 months of start date from the American Academy of Professional Coders. Experience
    • Minimum of two years clinical nursing experience. Other Skills, Competencies and Qualifications
      • Ability to use independent judgment and access quality metrics objectively and professionally.
      • Ability to effectively communicate verbally and in writing with all physicians and staff members, at all levels of the organization.
      • Experience with Microsoft office products preferred
        
        • Excel experience a plus

Keywords: Unity Health Network, Cuyahoga Falls , RN Manager, Population Health & Clinical Coding, Healthcare , Cuyahoga Falls, Ohio