Anthem Inc. Virginia Jobs

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Elevance Health Mgr Medicare Risk Adj & Coding in Arlington, Virginia

Mgr Medicare Risk Adj & Coding

  • Job Family: Medical and Clinical

  • Type: Full time

  • Date Posted:Jul 20, 2022

  • Req #: PS73647


  • CA, Cerritos

  • Arizona, Arizona

  • Virginia, Virginia

  • Nevada, Nevada

  • California, California


CareMore is a proud member of the Elevance Health family of brands, offering clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.

Remote Based but may occasionally need to report to a CareMore corporate office in Cerritos, CA.

*Also open to candidates that Reside within 50 miles from an Elevance Health and/or CareMore office in the states of either Nevada, Arizona or Virginia.

The Mgr Medicare Risk Adj & Coding is responsible for strategic oversight of our Medicare risk adjustment recapture program, supporting our network primary care providers. In addition, this role manages a team of coding professionals in the identification, collection and assessment of claim/encounter information as it pertains to CMS guidelines. Additional responsibilities include risk adjustment operations, provider education, data analysis, and audits. This is an exciting opportunity for the ideal candidate who has extensive risk adjustment experience and can utilize that knowledge for strategic program delivery.

How will you make an impact:

  • Proactively identify and plan for program enhancements.

  • Work cohesively with cross-functional teams across business units.

  • Partner with internal and external stakeholders.

  • Oversee day to day operations.

  • Ensure compliance with mandated and corporate policies.

  • Hire, train, coach, counsel, and evaluate performance of direct reports.

Minimum Requirements:

  • Requires either a CPC, CPC-H, CCS, or CCS-P certification and minimum of 2 years of experience in risk adjustment/healthcare industry ; or any combination of education and experience, which would provide an equivalent background.

  • Requires AAPC or AHIMA coding certification.

  • Local travel may be required.

Preferred Skills, Capabilities and Experiences:

  • CRC, CDEO, CDIP certifications highly preferred.

  • Expertise in Medicare Risk Adjustment Programs strongly preferred.

  • Excellent communication skills, ability to present metric information internally and to external matrix partners highly preferred.

  • BA/BS in Health Care or Business preferred.

  • RN, LPN, or foreign physician preferred.

Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.

EEO is the Law

Equal Opportunity Employer / Disability / Veteran

Please use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.

  • EEO Policy Statement

  • EEO is the Law Postero

  • EEO Poster Supplement-English Version

  • Pay Transparency

  • Privacy Notice for California Residents

Elevance Health, Inc. is an E-verify Employer

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