Massachusetts Jobs

Become a part of our caring community and help us put health first

This role is embedded within the clinical education team and will work also closely with Coding operations team and Clinical Excellence team under the CenterWell Primary Care Organization. This role reports to Associate Director of coding education and has a dotted line reporting to divisional clinical educators. Clinical Coding Educator identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. This will be done in close collaboration with the divisional clinical educator and insights from coding operations team and clinical excellence team. The training responsibilities could include chart review, data review, sessions providing 1:1 feedback to providers, small and large group provider sessions. In this role, the educator makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

The main responsibilities of the role are:

• Under the guidance of AD, Coding Education, the clinical coding educator partners with several key stakeholders and departments (clinical education, operational coding, clinical excellence, clinical leadership) to identify, understand and assess coding education needs for the assigned market.

• Based on the above assessment, will partner with clinician educator to review charts, and provides feedback in 1:1 provider meetings, and conducts small and large group education sessions. All education will be aimed at high quality documentation and adherence to PCO documentation standards.

• Actively seeks feedback from providers receiving training (learner feedback surveys) and from clinical leaders to pivot educational strategy and approach where needed.

• The educator will create documentation summarizing provider coding and documentation performance metrics as needed for action planning and socializing with leaders.

• They will support the development of educational materials and slide decks for providers re: provider coding and documentation and work closely with learning team when learning design support is needed

Use your skills to make an impact

Required Qualifications

• A minimum of one year experience as a CPC (Certified Professional Coder) certification through AHIMA or AAPC

• A minimum of two years coding training experience

• A minimum of two years experience in medical coding collaboration with healthcare providers

• Medical record review knowledge

• Medicare Risk Adjustment knowledge

• Extensive knowledge of coding guidelines (i.e. ICD-10)

• Comprehensive knowledge of MS Word, Excel and PowerPoint

• Problem solve complex issues

• Guide business and leadership in process improvement

• Excellent public speaking and presentation skills

Preferred Qualifications

• Bachelor's degree

• Certified Risk Coder (CRC)

• Experience interacting with healthcare providers

Additional Information

• Incumbent must be willing to work Central or Eastern Hours: 8 am - 5 pm / M-F

• Preferred locations include: Eastern or Central Markets

• Occasional travel across markets; <25% annually

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$57,700 - $79,500 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Conviva: Conviva Care Centers provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of Humana's Primary Care Organization, which includes CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Equal Opportunity Employer

It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. https://www.eeoc.gov/sites/default/files/migratedfiles/employers/eeocselfprintposter.pdf

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact yourcareer@humana.com for assistance.