Risk Adjustment Practice Support Specialist

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

What Youll Do

• Conduct on-site and virtual visits with healthcare providers and office staff to support AWV performance documentation and workflow optimization.
• Manage a caseload of physician practices building trust and providing ongoing education and support.
• Collect required medical records and documentation to address AWV gaps and incomplete submissions.
• Document all visits observations and identified needs for practice improvement.

• Prepare and maintain various performance and operational reports including:
  • Monthly progress and summary reports for assigned offices
  • AWV incentive tracking (as required)
  • PAF forms upon request
  • Incomplete or rejected documentation reports
  • Vendor reports for coordinator distribution
• Create AWV calling lists for QCC outreach (priority lists embedded clinic days special projects etc.).

• Coordinate and collaborate with internal departments to support effective workflow and communication for the embedded NP program.
• Partner with the NM team to support provider onboarding and clinic day preparation.
• Coordinate vendor calling efforts and NP availability.
• Collaborate with offices NMs and Regional Managers to resolve escalations.
• Maintain and save progress reports ensuring accuracy and accessibility.
• Attend all meetings and calls related to the NP program.

• Prepare and submit check requests to finance.
• Order track and process incentive gift cards.
• Prepare forms and distribute physical or egift cards as needed.

• Support provider offices in improving year-over-year AWV submission rates targeting 80% for senior lines of business.
• Utilize all available tools and resources to support Performance Programs initiatives.
• Assist practices in identifying operational barriers that hinder encounter data capture.
• Conduct practice assessments and use findings to guide workflow redesign and create SMART goals.
• Recommend opportunities for improvement and assist with office workflow redesign to support efficiency and documentation accuracy.

Qualifications

• Reliable transportation and valid drivers license
• Ability to travel approximately 50% of the time within Los Angeles County (primarily Los Angeles with occasional travel to the South Bay area as needed)

• High school diploma or equivalent required.
• Associate degree in Healthcare Administration Public Health or a related field OR equivalent work experience.

• 2 years of experience in a healthcare setting such as physician practice MSO IPA or health plan.
• Experience supporting clinical workflows documentation or practice operations.
• Experience working with Annual Wellness Visits (AWVs) and knowledge of CMS guidelines.
• Prior experience conducting onsite fieldwork provider office support or account management.
• Experience collecting and reviewing medical records or encounter documentation.
• Strong experience preparing and analyzing performance and tracking reports.
• Proficiency with population health or analytics tools (e.g. Cozeva or similar platforms).
• Strong computer skills including:
  • Microsoft Excel (reports tracking logs exporting data)
  • Outlook and Teams/Zoom for virtual sessions
  • Shared drive and document management
• Ability to analyze data identify gaps and communicate performance outcomes.
• Excellent verbal and written communication skills especially when working with providers NPs office managers and vendors.
• Strong organizational and time-management abilities.
• Ability to independently conduct training on Cozeva documentation requirements and AWV processes.
• Experience coordinating multi-department initiatives such as embedded NP programs.
• Valid drivers license and ability to travel up to 50% within Orange and Los Angeles Counties.
• Ability to work independently with minimal supervision.
• Understanding of HIPAA and confidentiality standards.

• Fluency in Spanish and/or Chinese (Cantonese/Mandarin)

Environmental Job Requirements and Working Conditions

• The national target pay range for this role is $33 - $40 per hour. Actual compensation will be determined based on geographic location (current or future) experience and other job-related factors.
• The home office of this department is located at 600 City Parkway West 10th Floor Orange CA 92868.
• This role follows a hybrid work structure where the expectation is to work onsite and at home on a weekly basis. Approximately 50% travel is required in designated market(s).
• The work hours are Monday through Friday standard business hours.