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CoxHealth

Hospital network with clinics and ERs

Risk Adjustment Manager

Risk ManagementConfirmed live in the last 24 hours
Full-timeSpringfield, MO, USANo salary listedHybrid

About the Job

Requirements

  • A bachelor's degree in Accounting, Finance, Business, or a related field, or eight years of relevant experience.
  • At least five years of experience in accounting or finance, public health, health administration, health insurance, or a health-related field.
  • Knowledge of governmental and other regulatory standards, requirements, and guidelines related to risk adjustment and compliance.
  • Knowledge of personal computers and software, including computerized programs.
  • Ability to maintain accurate records.
  • Ability to communicate effectively, both orally and in writing.
  • Ability to establish and maintain effective, cooperative working relationships with staff and network providers.
  • Ability to assume responsibility and exercise good judgment in making decisions within the scope of the position's authority.
  • Ability to work effectively under pressure, complete tasks accurately within established timelines, prioritize tasks, and meet deadlines.
  • Ability to maintain confidentiality.

Responsibilities

  • Manage and coordinate the risk adjustment programs for Cox HealthPlans.
  • Work with other staff and leaders within Cox HealthPlans to ensure risk-adjusted revenue matches members' actual health status.
  • Understand the financial aspects of risk adjustment models, analyze the program, and provide meaningful analytics to leadership and others.
  • Develop, design, and execute risk adjustment operational strategies and processes based on financial analysis.
  • Ensure compliance with all policies and risk adjustment regulations.

Desired Qualifications

  • Experience with risk adjustment programs, government programs compliance, and managed care.
  • Previous supervisory experience.
  • Knowledge of the principles of statistics.

About the Company

CoxHealth

Hospital network with clinics and ERs

CoxHealth operates as a regional health system with six hospitals, more than 80 clinics, five emergency rooms, and about 13,000 employees across southwest Missouri. It delivers a wide range of medical treatments and services through its network, coordinating primary, specialty, urgent, and hospital-based care to meet patient needs. The system’s care works by connecting hospitals, clinics, and ERs under one network to provide consistent, accessible health services and care pathways for patients. CoxHealth differentiates itself by being the area leader in health care and community involvement, leveraging a large regional footprint and a strong commitment to community health as part of its mission. Its goal is to improve the health of the communities it serves and to be the best for those who need care.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Springfield, MO
Founded
1906

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