Risk Adjustment Specialist II - Non-Clinical (Remote) - Healthcare Operations and Strategy

Join the Centene Team as a Risk Adjustment Specialist II and Shape the Future of Healthcare Are you passionate about improving healthcare outcomes and driving provider performance? Centene, a leading diversified, national healthcare organization, is seeking a highly skilled Risk Adjustment Specialist II to join our team. As a non-clinical specialist, you will play a critical role in enhancing provider engagement, coding, and documentation competencies, ultimately contributing to the health and well-being of our 28 million members. About Centene and Our Culture At Centene, we are committed to transforming the health of our communities, one person at a time. With a focus on diversity, equity, and inclusion, we value the unique perspectives and experiences that each team member brings. Our culture is built on a foundation of respect, empathy, and collaboration, allowing us to deliver high-quality healthcare services that meet the evolving needs of our members. Our Mission and Values Our mission is to improve the health and well-being of our members and the communities we serve. We are guided by a set of core values that emphasize: Member-centricity : We prioritize the needs and experiences of our members. Integrity : We operate with transparency, honesty, and ethics. Respect : We value diversity, equity, and inclusion. Accountability : We take ownership of our actions and outcomes. Excellence : We strive for continuous improvement and innovation. Job Summary and Responsibilities As a Risk Adjustment Specialist II, you will utilize risk adjustment methodologies, principles, and knowledge of managed care organizations to drive provider performance and improve coding and documentation competencies. This is a unique opportunity to work in a hybrid remote arrangement, with flexibility to work from home and occasional travel to areas surrounding Tempe and Tucson, Arizona. Key Responsibilities: Provider Engagement and Education : Develop collaborative relationships with providers to educate and improve Risk Adjustment coding and documentation competencies. Training and Materials Development : Use knowledge of ICD10 guidelines to develop trainings and coding materials that enhance providers and staff engagement in coding and documentation initiatives. Data Analysis and Reporting : Utilize advanced Excel data and reporting skills to identify Risk Adjustment trends, barriers, and develop strategies and best practices for engagement. Communication and Collaboration : Collaborate within the health plan to develop newsletters and facilitate provider webinars and trainings. Claims and Medical Record Review : Apply clinical coding knowledge to review claims and medical records for appropriate documentation and coding. Independent Critical Thinking and Decision Making : Rely upon independent critical thinking and decision-making skills to assist providers with inquiries and barriers. Other Duties : Performs other duties as assigned and complies with all policies and standards. Requirements and Qualifications Education and Experience: Bachelor's Degree : In Health Promotion, Public Health, Health Administration, Business Administration, or a related field. Experience : 3+ years of equivalent experience in Health Insurance, Customer Service, Claims, or Provider Office. Knowledge : Knowledge of healthcare, managed care, and Risk adjustment methodologies is highly preferred. Skills and Competencies: ICD10 Coding Knowledge : Familiarity with ICD10 guidelines and coding principles. Data Analysis and Reporting : Advanced Excel skills and ability to analyze and interpret data. Communication and Interpersonal Skills : Excellent communication, interpersonal, and presentation skills. Independent Critical Thinking and Decision Making : Ability to work independently and make sound decisions. What We Offer Compensation and Benefits: Competitive Salary : $25.97 - $46.68 per hour, depending on experience and qualifications. Comprehensive Benefits Package : Health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off, and holidays. Flexible Work Arrangements : Hybrid remote work arrangement with flexibility to work from home and occasional travel. Career Growth and Learning Opportunities: Professional Development : Opportunities for growth and development in a dynamic and evolving industry. Training and Education : Access to training and education programs to enhance skills and knowledge. Collaboration and Teamwork : Opportunity to work with a diverse and talented team. Why Join Centene? At Centene, we are committed to creating a workplace culture that values diversity, equity, and inclusion. We believe that our differences make us stronger and more resilient. By joining our team, you will have the opportunity to: Make a Meaningful Impact : Contribute to the health and well-being of our 28 million members. Grow and Develop : Access opportunities for professional growth and development. Work with a Diverse Team : Collaborate with a talented and diverse team. Enjoy a Flexible Work Environment : Take advantage of our hybrid remote work arrangement. How to Apply If you are a motivated individual ready to contribute to a thriving team, we encourage you to apply now! Please submit your application through our website: We are excited to review your application and discuss this opportunity further. Apply for this job