Senior Coding Educator

The Senior Coding Educator role:

• Identifies documentation and coding improvement opportunities, offering insights into operational and clinical best practices within risk adjustment.
• Collaborates with market operations, finance, and clinical teams to encourage providers to adopt optimal risk adjustment practices.
• Develops a deep understanding of Humana’s risk adjustment programs, strategically assessing improvement areas with available resources.

Key responsibilities:

• Conduct performance analysis and present formal reports to providers regularly, giving actionable solutions for enhanced documentation and coding accuracy.
• Successfully execute action plans to impact risk adjustment deadlines and report progress.
• Assist providers in grasping the CMS-HCC Risk Adjustment program.

Required Skills:

• Engages with providers to boost participation in performance improvement initiatives.
• Demonstrates in-depth knowledge of risk adjustment KPIs and CMS payment models.
• Possesses expert facilitation and presentation skills, including online delivery.