Full-Time

VP – HCC Coding Operations & Execution

Posted on 5/14/2024

Datavant

Datavant

501-1,000 employees

Secure healthcare data integration and analytics

Financial Services
Data & Analytics

Senior

Remote in USA

Required Skills
Communications
Management
Data Analysis
Requirements
  • Minimum of a Bachelor's degree in business, finance, analytics, healthcare delivery, public policy or a related field is required.
  • Seven (7) or more years' experience in health plan, health technology for health plans, risk & quality at a plan or vendor, or a consultant in one or more of those areas.
  • Five years experience with HCC coding leadership
  • Four years experience in a client success / client facing role
  • AAPC or AHIMA certification preferred.
  • Strong analytical skills needed to prepare and analyze data to drive KPIs and process improvements within the department.
  • Strong leadership and management skills to directly manage a team/department.
  • Strong communication skills; ability to present information in a concise manner to multiple organizational levels including Board of Directors
  • Must be able to travel a minimum of 50% of the time (more travel may be required at times)
Responsibilities
  • Strategy, planning and execution of the Risk adjustment coding business including ACA/Exchange, Medicare Advantage, and Medicaid plans.
  • Demonstrate and pass on expert knowledge in HCC risk adjustment methodologies and industry-leading solutions and strategies to drive optimized results.
  • Partner with Analytics to develop new predictive, analytic and reporting tools to glean actionable insights into current performance and new opportunities and leverage a network of experts - internal and external - to enhance Risk Adjustment innovation and performance.
  • Monitor risk adjustment submissions as compared to expected revenue and proactively address gaps in data submissions and impacts to forecasting and budgets.
  • Improve monitoring and auditing protocols to ensure internal and vendor compliance with all applicable regulations and risk adjustment data validation audits (RADV).
  • Leverage market insights to monitor trends and external landscape, and to inform capability strategies and customer use case scenarios.
  • Consult with and support Payer Client Services team with all Risk Adjustment programs and initiatives.
  • Ensure operational integration of contractual requirements resulting in adherence to quality standards and performance expectations as required and strive to exceed established service level agreements.
  • Oversight of the Coding management team and staff in all departmental functions including implementing best practices in talent acquisition for HCC coders, overseeing onboarding, staffing plans and staff performance to ensure optimal talent management and utilization.
  • Develop and manage a multi-million dollar department budget.
  • Negotiate, direct and oversee the administration of contracts, select and performance manage key vendor partners, and foster new relationships and partnerships with cutting edge service providers.
  • Direct oversight of team/department and responsibilities around managing, developing, and handling employment actions of direct staff and manager
  • Provide training sessions and educational resources to our client success team on the use of our coding software, coding guidelines, industry update and best practices on how to sell and discuss coding offerings with clients.
  • Offer ongoing support and troubleshooting assistance to address client inquiries, issues, and challenges related to coding processes or system usage.
  • Conduct regular check-ins and meetings with account managers and coding clients to understand their evolving needs, address concerns, and provide proactive support.

Datavant is a leading healthcare data logistics company dedicated to improving patient outcomes by seamlessly integrating diverse health data sources. They excel in providing advanced technologies that securely connect disparate patient-level data while maintaining stringent privacy standards. This company promotes a culture of innovation and excellence making it an ideal workplace for those passionate about making a tangible impact in healthcare through cutting-edge data management solutions.

Company Stage

Series B

Total Funding

$80.5M

Headquarters

San Francisco, California

Founded

2017

Growth & Insights
Headcount

6 month growth

0%

1 year growth

28%

2 year growth

174%

Benefits

Competitive Salaries & Rewards

Generous Parental & Family Leave

Ability to work anywhere in the US and Canada

Meaningful equity

Competitive Benefits – Full Family Coverage

WFH Stipend & Monthly Credit

Commitment to Learning & Development

Unlimited PTO