Hierarchy Condition Category (HCC) Compliance Manager Job in Northridge 91325, California US
Company Description
Heritage is a national physician management company with two over billion dollars in revenue and 3,000 employees. Heritage owns and manages its provider network to offer comprehensive health insurance coverage for a range of medical care needs in Southern California and New York.
Job Description:
The HCC Compliance Manager is primarily responsible for ensuring that the Heritage groups meet statutory and regulatory requirements relating to CMS and Coding Clinic guidelines and implementation of HCC programs.
A key component is also to build partnerships with all levels of management and employees at the various groups who are involved in HCC related activities, to support consistency of decision making and approach to risk mitigation. The individual also may advise Senior Management at Heritage of potential compliance risk areas and recommend and implement appropriate action plans.
Additionally, the individual will conduct regular and ad hoc audits, train providers on HCC related applications and be a liaison between Heritage and Health Plans for activities related to HCC projects and audits.
Job Qualifications
Requirements:
- CPC and Bachelor's Degree
- Minimum 3 years of HCC and supervisory experience
- Exceptional written and verbal communication skills
- Excellent problem solving skills
- Proficient in Microsoft Suite
Experience in creating and implementing policies is a plus