Director of Risk Adjustment - Remote

Overview

The Director of Risk Adjustment will lead a team focused on enhancing healthcare strategies through analytics, IT systems, and operational processes, ensuring effective collaboration across departments and vendors.

In Short

• Lead a dynamic team in risk adjustment initiatives.
• Oversee vendor management and ensure compliance with regulations.
• Manage complex data transfers and system integrations.
• Drive continuous process improvement and operational efficiency.
• Coordinate cross-functional initiatives and track project progress.
• Develop executive presentations and reports for stakeholders.
• Engage with internal and external stakeholders for alignment.
• Ensure adherence to CMS and HHS regulations.
• Provide tools and training for operational teams.
• Identify new opportunities and technologies in risk adjustment.

Requirements

• Bachelor’s Degree in a relevant field.
• 7+ years of relevant experience in healthcare or similar industries.
• 2+ years of management experience in a healthcare organization.
• Expertise in risk adjustment coding operations.
• Strong understanding of managed care and value-based care.
• Knowledge of regulatory compliance and data validation.
• Familiarity with EHR systems and claims processing.
• Master’s degree preferred.
• Excellent communication and leadership skills.
• Ability to drive strategic initiatives and improve provider engagement.

Benefits

• Comprehensive health, financial, and security benefits.
• Participation in the Management Incentive Program.
• Opportunities for professional growth and development.
• Collaborative work environment with innovative healthcare solutions.
• Flexible working arrangements, including remote options.