EDUCATION** **Required** + Bachelor's Degree in a Health related field or current state RN/LPN license **Substitutions** + 6 years of combined experience with RN/LPN, Risk Adjustment, HCC coding, medical coding/billing HEDIS and/or healthcare related management **Preferred** + None **EXPERIENCE** **Required** + 6 years of combined experience with RN/LPN, Risk Adjustment, HCC coding, medical coding/billing HEDIS and/or healthcare related management To Include: + 3 years with government markets and working within all Compliance and Coding guidelines + 1 year in a management or leadership role **Preferred** + 3 years in a clinical nursing role, in a hospital or office setting (RN or LPN) + 3 years in the Health insurance field + 3 years of mentoring others + 1 year of Project management + 1 year with Total Quality Management (TQM) concepts, techniques, process and outcome measurements experience + 1 year working with Healthcare Effectiveness Data and Information Set (HEDIS) **LICENSES or CERTIFICATIONS** **Required** (any of the following) + Certified Professional Coder (CPC) + Certified Coding Specialist (CCS) + Registered Health Information Administrator (RHIA) + Clinical Research Coordinator (CRC) **Preferred** + Licensed Practical Nurse (LPN) + Registered Nurse (RN) **SKILLS** + Excellent verbal communication skills + Professional manner and excellent written communication skills, including a familiarity with a variety of writing styles + Demonstrated computer literacy and knowledge of information systems and comparative data bases. Working knowledge of Microsoft Office software (Word, Excel, Access, PowerPoint, etc.) + Well-developed, analytical and problem solving skills with the ability to understand and interpret clinical data + Must be able to communicate with medical administrators, including Medical Directors and Physician Advisors related to problem identification, action plan implementation, ongoing monitoring and problem resolution **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Remote Teaches / trains others regularly Frequently Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required No Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title.