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Prospective Program Solutions & Performance Regional Advisor Market Operations - Northeast Region
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- This role is responsible for supporting Cigna Medicare Advantage risk adjustment prospective programs, solutions, and performance in aligned operational region serving as a liaison between Markets and Provider Performance Enablement teams, Provider Education, and the Risk Adjustment Operations teams.
- The role will work under the direction of the Senior Manager - National Lead Provider Education to reach overall operational market goals in conjunction with market Provider Performance Enablement teams and the Risk Adjustment Operations team.
- The role requires expertise in areas that include performance management/analytics, data exchanges, electronic medical record systems, provider workflow and processes, health information management, risk adjustment operations (particularly on the prospective side), value-based care, ICD-10, CPT and HCPCS coding principles and guidelines, and population health management.
- Function as a Risk Adjustment and Quality SME to support engagement with market and matrix partners and supports in a consultative way to solution for barriers identified impacting participation with Cigna RA prospective programs.
- Documentation Integrity, Coding or Health Information Management Certification through AHIMA, AAPC or ACDIS preferred.
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