Vice President of Risk Adjustment - Remote

Overview

The Vice President of Risk Stratification plays a critical role in shaping and implementing a strategic approach to risk stratification. This senior leadership position focuses on utilizing data analytics to identify high-risk populations, allowing for targeted interventions and improved care management to mitigate potential adverse events.

In Short

• Leads a team of subject matter experts and analysts to guide risk assessment methodologies.
• Serves as the primary liaison for Compliance and Legal projects.
• Partners with tech teams to design sophisticated risk algorithms.
• Collaborates with Analytics to analyze large datasets for patient risk profiles.
• Develops a roadmap for operationalizing repeatable and cost-effective actions.
• Tracks KPIs related to risk stratification across contracts.
• Partners with clinical teams to communicate risk assessments and interventions.
• Ensures adherence to healthcare regulations and oversees auditing practices.

Requirements

• Bachelor’s Degree with 15+ years experience in healthcare.
• 5+ years leading a comprehensive Risk Stratification program.
• Deep knowledge of Risk Stratification in Medicare Advantage and Commercial plans.
• Proven track record of collaboration with clinical and operational teams.
• Deep understanding of healthcare terminology and clinical conditions.
• Ability to manage multiple deadlines and communicate complex data insights.
• Proficiency in data analysis techniques and statistical modeling.
• Familiarity with data warehousing and healthcare information systems.

Benefits

• Opportunity to lead strategic initiatives in healthcare.
• Collaborative work environment with cross-functional teams.
• Impactful role in improving healthcare delivery and patient outcomes.
• Professional development opportunities in a senior leadership position.