You can make a difference in people’s lives every day. When you join UCLA Health, you’ll be working at an institution that provides leading-edge care to the people of L.A. and throughout the world. We provide our team members with the environment and support to do amazing work, because each and every one of them plays a vital role in our commitment to care.
Note: Position is onsite with the consideration of flexible hybrid
Take on an important leadership role within an award-winning health system. Help improve patient experiences as part of a world-class healthcare team. Take your career in an exciting new direction. You can do all this and more at UCLA Health.
As a key leader within our Medicare Advantage team, you will develop and execute of strategies, programs, and projects while managing key performance indicators to drive operational excellence. You will be responsible for leading, developing, and facilitating the team to ensure the application of industry best practices related to accuracy, efficiency, and adherence to all regulatory and CMS compliance requirements. You will manage the coding consultants who provide audit, coding expertise, and provider education to internal and external clients. You will also serve as a Subject Matter Expert for Medicare Advantage risk adjustment.
We’re seeking a self-motivated, flexible, goal-driven, service-oriented leader with:
- This role will require occasional travel to local provider offices
- Required Certified Professional Coder (CPC-I) certification, Certified Risk Adjustment (CRC) coder AAPC certification, and Certified Professional Medical Auditor (CPMA) certifications from AAPC (to obtain CPMA within 120 days from date of hire, if applicant does not currently possess)
- Six or more years of risk adjustment experience
- Three to five years of provider education experience with the development of educational materials and presentations
- Five or more years of physician billing/coding experience
- Previous managerial experience
- Exceptional relationship-building skills with clinical and non-clinical personnel
- Knowledge of the Medicare Advantage STARS program and NCQA technical specifications
- In-depth understanding of HIPAA
- Extensive knowledge of HCC models V24 and V28
- Familiarity with claims and encounter data processes
- Experience conducting mock RADV or actual RADV
- Related Bachelor’s degree and RN licensure preferred
- Strong leadership, communication, prioritizing, and interpersonal skills
- Ability to develop, implement, and evaluate methods and systems to improve efficiency
- Expertise in leading cross-functional workgroups
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California. We’re also home to the world-class medical research and clinical education capabilities of the David Geffen School of Medicine. Through the efforts of our outstanding people, we have become Los Angeles’ trusted provider of exceptional, compassionate patient care. If you’re looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.
EMPLOYMENT SCAM ALERT:
UCLA Health Recruitment is currently being targeted by scam artists through external job board sites. Review some tips in order to avoid becoming targeted. El reclutamiento de salud de UCLA actualmente está siendo atacado por estafadores a través de sitios de juntas de trabajo externos. Revisar algunos consejos para evitar ser apuntado.
“The environment is nurturing and fosters growth. When I come to work, I know what I'm doing matters.”
VINCENT, Sr. CLS Specialist, Toxicology
MONICA
I've been blessed to touch so many lives through my serving. It's a privilege to uplift other employees with words of encouragement and a smile.
SOZIT
The first thing i noticed when i joined the team was how everyone is very welcoming and friendly with supportive management. I did not feel like an outsider.
EDGAR
Once I joined, I knew UCLA Health was THE place to be due to the growth potential and training offered
RENE
If you want to grow professionally, this is the right place for you.
ERA
We are family here. We support each other. We collect together.
ELIZABETH
It’s so diverse and inclusive here. There’s always the opportunity to share your thoughts. It's a place where you feel you belong.
JERRY
Your career path at UCLA Health will enable you to follow a myriad of avenues and turns. It opens up a wide variety of opportunities.
ORLANDO
There’s a togetherness and higher level of commitment to teamwork at UCLA Health. We are several groups and teams that work together with a common goal which is to improve our patients experience.
DAVID
UCLA Health walks the walk and talks the talk! It's an incredible feeling to work for an organization that always puts the patient first. I am honored to work in full alignment with the UCLA Health Mission and Vision.
DR. ISLA GARRAWAY
UCLA has incredible resources and a team science approach. The ability to work with collaborative teams and access the amazing resources around campus is the best part about being at UCLA.
RADU
UCLA is very diverse in its personnel as well as its many research fields studied
JENNA
UCLA Health provides so many opportunities to exchange ideas, share moments and grow. I have learned a lot about team management and relationship building.
SHARON
I was looking for a job to further my career and continue to improve and learn as a therapist.
TARO
I have been blessed to be surrounded by supportive colleagues who aspire me to be the best version of myself.