Find Your User Group

The HCC Coder User Group


These user groups are telephonic meeting groups, chaired by RISE HCC coding faculty, and made up of professional coders and CDI specialists focused on risk adjusted government programs such as Medicare Advantage, ACA marketplace, and Medicaid lines of business.  The coders work for health plans and provider organizations, for the most part, although some work for vendors / service providers or as independent contractors. We also have some actuaries involved in our group meetings, as well as compliance specialists.

The purpose of the user group is to bring up current coding / documentation questions or challenges where a member wants to get input or advice from colleagues and peers. Often the open dialogue format provides an in-depth conversation that helps clarify or identify key factors considered to come to a final resolution.  This peer-based interactivity is the key to the success and popularity of this forum.

Their roles include all levels in their organizations from staff positions up through supervisor, manager, and director. They include job titles such as:

  • Director of Revenue Cycle, Audit and Education
  • Auditor
  • Billing Coordinator
  • Clinical Documentation Improvement Manager
  • Clinical Documentation Specialist
  • Coding Compliance Manager
  • Coding Manager
  • Compliance Review Specialist
  • Director of Coding
  • Director of Quality, Compliance & Education
  • Director, ACO & Population Health
  • Director, Coding & CDI
  • Director, Population Health
  • Provider Educator
  • HCC Coder
  • Manager, Revenue Cycle
  • Manager, Risk Adjustment

 


The Provider Engagement User Group


These user groups are telephonic meeting groups, chaired by RISE HCC coding faculty, and made up of professional coders and provider education specialists focused on engaging and educating provider offices on coding and documentation within a risk adjusted contract program.  The members of this group work for health plans and provider organizations, for the most part, although some work for vendors / service providers or as independent contractors.

The purpose of the user group is to identify current coding / documentation questions or challenges identified in coding or documentation patterns with contracted providers where a member wants to get input or advice from colleagues and peers. Often the open dialogue format provides an in-depth conversation that involves shared experiences (successes and failures) that help the group gain consensus on a best practice approach.  This peer-based interactivity is the key to the success and popularity of this forum.

Their roles include all levels in their organizations from staff positions up through supervisor, manager, and director. They include job titles such as:

  • Director of Revenue Cycle, Audit and Education
  • Billing Coordinator
  • Clinical Documentation Improvement Manager
  • Clinical Documentation Specialist
  • Coding Compliance Manager
  • Coding Manager
  • Compliance Review Specialist
  • Director of Coding
  • Director of Quality, Compliance & Education
  • Director, ACO & Population Health
  • Director, Coding & CDI
  • Director, Population Health
  • Provider Educator
  • Manager, Risk Adjustment

 


The Medicare Sales User Group


These user groups are telephonic meeting groups, chaired by RISE board members or select volunteers, and made up of sales leaders and staff from Medicare Advantage health plans, for the most part. We also have representatives from provider organizations that are closely aligned with plans, plus some participants that work for community partners of the association or those who work as independent contractors.

The purpose of the user group is to create a learning community among local and regional plans through sharing questions or challenges where a member wants to get input or advice from colleagues and peers. The topics cover a wide range of matters involving:

  • Best use of field sales resources, such as sales seminars, local community marketing, and relationship development with community organizations
  • The differences in staff utilization during lock-in
  • Broker channel management and FMO relationship management
  • Performance metrics and relative costs
  • Oversight, training, and compliance
  • AEP readiness preparation
  • Insourcing versus outsourcing call center service
  • The optimal temporary staffing models for AEP

Often the open dialogue format provides an in-depth conversation that involves shared experiences (successes and failures) that help the group gain consensus on best practice approaches, based on particular circumstances on the ground.  This peer-based interactivity is the key to the success and popularity of this forum.

Their roles include all levels in their organizations from staff positions up through all levels of the sales organization. They include job titles such as:

  • Channel Compliance and Oversight
  • Compliance Training Auditor
  • Director of Consumer Sales
  • Director of Inside Sales
  • Health Plan Sales Trainer
  • Manager, Director, VP Brokerage Sales
  • Manager, Outside Sales
  • Medicare & Individual Sales Executive
  • Medicare Sales Compliance Training Auditor
  • Medicare Sales Representative
  • Medicare Sales Supervisor, Manager, Director, Vice President
  • Sales Administration and Promotions Vice President
  • Sales Manager, Director, Vice President
  • Sales Training & Program Manager
  • Senior Manager, Business Development
  • Vice President of Business Performance

 


The Medicare Marketing User Group


These user groups are telephonic meeting groups, chaired by RISE board members or select volunteers, and made up of marketing leaders and staff from Medicare Advantage health plans, for the most part. We also have representatives from provider organizations that are closely aligned with plans, plus some participants that work for community partners of the association or those who work as independent contractors.

The purpose of the user group is to create a learning community among local and regional plans through sharing questions or challenges where a member wants to get input or advice from colleagues and peers. The topics and questions cover a wide range of matters such as:

  • While direct mail is still king, what are best practices in the digital channels?
  • What are the best benchmarks for performance metrics and relative costs?
  • Vendor selection: one-stop-shop agencies versus separate niche specialty vendors?
  • AEP readiness preparation for member communications
  • How long do you find it takes to break even with age-ins?
  • How do you market to age ins over 65?
  • How do you market to commercial members aging in?
  • How do you switch it up to market to DSNP during lock-in?

Often the open dialogue format provides an in-depth conversation that involves shared experiences (successes and failures) that help the group gain consensus on best practice approaches, based on particular circumstances on the ground.  This peer-based interactivity is the key to the success and popularity of this forum.

Their roles include all levels in their organizations from staff positions up through all levels of the sales organization. They include job titles such as:

  • Campaign Manager, Communications
  • Chief Experience Officer
  • Communications consultant, manager, director
  • Community Outreach and Sales Rep
  • Digital Marketing (Manager, Director)
  • Direct Response Marketing Coordinator
  • Director Creative & Brand Strategy
  • Director of Broker and Community Relations
  • Director of Member Experience & Acquisition
  • Director, Loyalty & Consumer Experience
  • Director, Market Strategy and Analytics
  • Director, Sales & Marketing
  • Executive Director, Customer Experience and Corporate Innovation
  • Executive Marketing Director
  • Government Regulatory Communications
  • Growth Marketing Manager
  • Lead Marketing Specialist
  • Manager of marketing and digital strategy
  • Manager of Sales and Marketing
  • Manager, Community Engagement
  • Marketing Campaign Leader
  • Marketing (Specialist, Manager, Director, Vice President)
  • Medicare Document Specialist
  • Member Communications Coordinator
  • Strategist

 


The SDoH User Groups


These user groups are telephonic meeting groups, chaired by RISE board members or select volunteers, and made up of industry leaders and staff from health plans and health care providers. We also have representatives from community-based organizations who are closely aligned with Social Determinants of Health, as well as participants who work for community partners of the association or those who work as independent contractors.

The purpose of these user groups is to meet virtually to discuss pressing topics and learn from others in the industry. Three user group streams will meet to discuss pressing topics and learn from others in the industry. Quarterly cross-sector meetings will also take place amongst the groups.

The four SDoH user groups are as follows:

Health Plans User Groups

Join a group of health plans across the nation to benchmark best practices and exchange ideas with peers, facilitated by RISE Steering Committee Chairs. Gain insights into other payers’ SDoH efforts with tactical takeaways on funding, contracting issues, lessons learned in operationalizing SDoH pilots (including data sharing, metrics and outcomes) and best practices in convening both internally and externally to ultimately scale SDoH programs. Actively participate, share your ideas, and identify approaches that might make a difference for your organization. 

Health Care Providers User Group

 Join a group of health care providers, including health systems, hospitals ACO’s, physician practices and more to discuss SDoH best practices with industry peers. Gain insights into how other healthcare providers are partnering across the ecosystem to provide best-in-class care to the most vulnerable populations. Key topics will be focused around what’s working and what’s not in various SDoH programs (food, housing, transport, etc.), tapping into funding streams and lessons learned in operationalizing SDoH pilots (including data sharing, metrics and outcomes). Actively participate, share your ideas, and identify approaches that might make a difference for your organization. 

CBO and Non-Profit User Group

 Join a group of community-based organizations / non-profits to discuss opportunities and overcoming roadblocks in executing SDoH programs and partnering with other healthcare stakeholders, facilitated by RISE Steering Committee Chairs. Hear how other CBO’s are successfully operationalizing SDoH programs and gain insights into funding streams, overcoming contractual issues, how each sector can utilize the strong suits of the other and keys to “speaking the same language”. Actively participate, share your ideas, and identify approaches that might make a difference for your organization. 

SDoH Across the Healthcare Ecosystem User Group

 Drive this industry forward by connecting with cross-sectional stakeholders from payers, providers, CBO's, government and funders to discuss actionable, tactical and scalable solutions to SDoH challenges and drive social good. Discuss and receive the feedback, guidance, and experiential insights into best practices around convening, contracting, funding and more! Get in the mix, share your ideas, and learn with the best.