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Medicare Advantage - Risk Adjustment Provider Education Content & Training Lead - Work from home at Cigna

Posted in General Business 30+ days ago.

Type: Full-Time
Location: Bloomfield, Connecticut





Job Description:

Remote, Work from home

This role will be responsible for developing and executing on a program for Provider Education content creation and training for Risk Adjustment for Cigna's Medicare Advantage Segment. The purpose of the role is to provide resources and tools to educate providers and internal teams on accurate and complete coding and documentation. This role will report for the Prospective Risk Adjustment Program Lead.


  • Identification and development of educational material to improve accurate & complete documentation, including but not limited to:

    • Disease Specific Documentation & Coding

    • Prospective Program external guides & training content support

    • Enhancement and support of reporting tools and training materials (internal/external)

    • Educational presentations, flyers, and digital magazines to support the education needs of our providers.



  • Serve as a Risk Adjustment Subject Matter Expert for Cigna Medicare Advantage

  • Development and maintenance of a Content Library for RFP responses & standardized content for internal teams use in external Provider Education

  • Development and facilitation of both internal & external trainings based on findings through audit results, CMCR and prospective program trends

  • Development of Cigna Medicare Advantage Risk Adjustment standards & guidelines specific to provider education and external materials and responsible for staying informed on the most up to date recommendations and guidelines, and addressing in Cigna MA standards as needed

  • Develop, maintain and/or update policies and procedures relative to provider education to ensure compliance across RA standards and guidelines

  • Facilitation and oversight of committee for external material review and approval, supported by legal, compliance and Medical Director(s).

QUALIFICATIONS :


  • 5 years or more prior experience with a Health Plan supporting risk adjustment operations and/or education for MA or Individual Medical business lines (MA experience strongly preferred)

  • Demonstrated competencies in Risk Adjustment and Coding from operational, financial and regulatory perspectives

  • Experience with provider education and engagement in risk adjustment

  • Extensive knowledge and adherence to ICD-10-CM/outpatient and CPT coding principles and guidelines

  • Prior experiences teaching/training others on correct coding guidelines and have the ability to present to large groups of Physicians/Providers

  • Ability to prioritize tasks with competing deadlines and collaborate with key business partners in a matrix environment

  • Excellent understanding of medical terminology, disease process and anatomy and physiology.

  • Working knowledge of CPT/Evaluation and Management guidelines, Working Knowledge of CMS Risk Adjustment and HCC Coding Process

  • Coding certification required through AHIMA or AAPC (at least one of the below):

  • Certified Professional Coder (CPC)

  • Certified Risk Adjustment Coder (CRC)

  • Certified Coding Specialist for Providers (CCS-P)

  • Registered Health Information Management Technician (RHIT)

EDUCATION:

  • Bachelor's Degree from an accredited college or university strongly preferred. Preferred field of study: business, math, finance, economics, actuarial science, healthcare administration or other related health care field

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 99,500 - 165,900 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna .

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

Cigna has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.





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