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Hill Physicians Medical Group - San Ramon, CA

posted 16 days ago

Full-time - Entry Level
Hybrid - San Ramon, CA
Hospitals

About the position

At Hill Physicians Medical Group, we're shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members. Join Our Team! Hill Physicians has much to offer prospective employees. We're regularly recognized as one of the "Best Places to Work in the Bay Area" and have been recognized as one of the "Healthiest Places to Work in the Bay Area." When you join our team, you're making a great choice for your professional career and your personal satisfaction.

Responsibilities

  • Coordinate initiatives supporting department objectives for Medicare Advantage, ACA and Medi-Cal lines of business, managing ad-hoc and long-term projects assigned by the Director, Government Programs.
  • Lead Hierarchical Condition Coding (HCC) improvement projects such as Annual Wellness Visit (AWV) campaigns and CMS STAR rating initiatives.
  • Research and resolve encounter errors.
  • Prepare for Centers for Medicaid Services (CMS) chart sweeps and Risk Adjustment Data Validation (RADV) audits, including medical record retrieval for non-HillChart practices.
  • Manage member assessment projects and champion the use of Cozeva for HCC performance outcomes and create pursuit lists for vendor outreach.
  • Identify opportunities for chart review activities throughout the year (e.g. working with practices on a regular basis during the year to retrieve medical records to capture chronic conditions).
  • Track program effectiveness and recommend expansion or discontinuation.
  • Communicate member outreach challenges, along with recommendations to resolve.
  • Weekly 2-day office work to either the San Francisco Bay Area, Sacramento, or Stockton offices.

Requirements

  • Strong organizational and communication skills to effectively communicate requests to provider office staff and vendors.
  • Proven project management experience handling complex, multi-faceted projects.
  • Exceptional ability to facilitate meetings with vendors, leveraging PowerPoint for clear and effective presentations.
  • Advanced skills in creating professional and visually compelling PowerPoint presentations.
  • Proficiency in Excel and Word.
  • Medical coding or medical office experience preferred (familiarity with CPT and ICD-10 coding).
  • High-energy, detail-oriented professional with a focus on task completion.
  • Valid Driver's License and proof of auto insurance.

Nice-to-haves

  • Bachelor's degree preferred with relevant course work or a minimum of 2 years related experience required.
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