VP, Risk Adjustment Performance

Responsibilities

• Develop and implement a multi-year Risk Adjustment business plan to improve RAF accuracy
• Design provider engagement strategies to enhance coding accuracy and documentation quality
• Lead and nurture a high-performing Risk Adjustment team focused on accountability and growth
• Maintain expertise in CMS regulations and industry trends to guide the organization
• Drive strategic initiatives in cross-functional steering meetings for integrated Medicare performance
• Utilize data analytics to identify Risk Adjustment opportunities and measure effectiveness
• Oversee Risk Adjustment accuracy and compliance activities, ensuring CMS audit readiness

Qualifications

• 15+ years of leadership experience in Medicare Advantage with Risk Adjustment and/or Stars accountability
• Proven track record in developing multi-year Risk Adjustment business plans
• In-depth expertise in HCC coding, RADV processes, and Medicare Risk Adjustment regulations
• Successful history of improving coding accuracy through provider engagement strategies
• Experience working in a complex, matrixed environment leading cross-functional teams

Benefits

• Comprehensive health, dental, and vision insurance coverage
• Retirement savings plans with company matching
• Generous paid time off and holiday schedule
• Ongoing professional development and leadership training opportunities
• Flexible work arrangements to support work-life balance