Risk Adjustment, Operations Manager
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Job Description
Operations Manager ensuring operational excellence and supporting audit data processes in healthcare. Collaborating cross-functionally to drive efficiency and quality through process improvements.
Responsibilities:
- Manage a multi-step medical document evaluation process with tight turnaround times, ensuring accuracy and consistency in responding to crucial external audit requests
- Oversee and coordinate production work with offshore teams, maintaining clear expectations and quality standards
- Identify opportunities for process improvement and implement changes that enhance scalability, transparency, and quality
- Communicate updates, risks, and recommendations clearly to cross-functional stakeholders
- Collaborate with risk adjustment coding experts to build a chart evaluation process that extracts the correct information in an efficient and meaningful manner
- Support special projects that require structured thinking, thoroughness, and cross-team collaboration
Requirements:
- 4+ years experience managing processes with tight turnaround times.
- Strong communication skills, both written and verbal.
- Ability to pull and analyze data using SQL to form independent insights, identify trends, and validate what’s working.
- Curiosity and comfort experimenting with AI (including LLMs) or other emerging tools.
Benefits:
- Employer sponsored health, dental and vision plan with low or no premium
- Generous paid time off
- $100 monthly mobile or internet stipend
- Stock options for all employees
- Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
- Parental leave program
- 401K program
- And more....
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