Senior Manager of Risk Adjustment Provider Enablement - Remote

Overview

Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.

Our vision is care that enables everyone to achieve their best health. So, we’re creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality. Homeward supports Medicare-eligible beneficiaries by partnering with health plans, providers, and communities to align incentives – taking full financial accountability for clinical outcomes and the total cost of care across rural counties.

Homeward is co-founded by a leadership team that defined and delivered Livongo’s products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.

In Short

• Lead Homeward’s external risk adjustment program for contracted providers.
• Drive provider enablement initiatives and serve as the key liaison to payer partners and participating practices.
• Operationalize Homeward’s RA enablement model including scorecard delivery and provider education.
• Lead discussions with payers on risk gap data and coding trends.
• Monitor provider recapture rates and collaborate with the data team on insights.
• Partner with internal stakeholders to refine workflows and develop new capabilities.
• 6+ years of experience in Medicare Advantage risk adjustment or healthcare operations.
• Strong interpersonal skills to influence and coach stakeholders.
• Familiarity with EMR systems and risk adjustment analytics platforms.
• Proven ability to lead cross-functional projects.

Requirements

• 3+ years of experience leading teams in a performance-driven environment.
• Certified Risk Adjustment Coder (CRC) or similar certification.
• Expertise in ICD-10-CM coding and CMS-HCC models.
• Deep knowledge of provider workflow dynamics and claims submission processes.
• Ability to navigate ambiguity and solve for new challenges.

Benefits

• Medical, dental, and vision insurance with 100% premium coverage for employees.
• Competitive salary and possible equity grant.
• Supplemental performance bonus opportunities.
• Relocation and travel reimbursement.
• Loan repayment support.
• Company-sponsored 401k plan + match.
• Generous paid time off.
• Comprehensive training provided.