Demonstrates understanding and working knowledge of key elements of Risk Adjustment Factor (RAF) and Hierarchical Condition Categories (HCC) model within 30 days of hire Demonstrates understanding and working knowledge of key elements of Quality STAR/HEDIS measures within 30 days of hire Rotation of telephonic on call coverage after hours. The ideal candidate for this role demonstrates a high level of clinical expertise in working with members with acute and chronic conditions and is responsible for assessment, diagnosis, treatment, plan, management, education, health promotion and care coordination for member health needs.