VP, Risk Adjustment Performance

🔥 22 minutes ago

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Alignment Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

💰 $135M Series C on 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health is dedicated to providing comprehensive care for Medicare members, emphasizing the needs of seniors, the chronically ill, and those who are frail. With a mission to transform senior healthcare, Alignment Health leverages a tailored care model and advanced technology to deliver high-quality, low-cost healthcare services. Their 24/7 concierge care team collaborates with trusted local providers to ensure that every member receives personalized care, reflecting the company's commitment to treating all members as valued family members.

📋 Description

• Develop and Execute the Multi-Year Risk Adjustment Business Plan • Establish, track, and drive performance targets and KPIs across all Risk Adjustment programs • Lead Provider Network Engagement for Risk Adjustment Performance • Build, Lead, and Develop the Risk Adjustment Team • Maintain Expert Regulatory and Competitive Intelligence • Drive Cross-Functional Governance and Strategic Alignment • Leverage Data and Analytics to Drive Performance Improvement • Oversee Risk Adjustment Accuracy, Audit Readiness, and Compliance

🎯 Requirements

• Minimum 15 years of progressive leadership experience in Medicare Advantage, with significant depth in Risk Adjustment and/or Stars • Demonstrated experience developing and executing multi-year Risk Adjustment business plans • Deep working knowledge of HCC coding, CMS Risk Adjustment data validation (RADV) processes • Proven track record of leading provider engagement strategies that produce measurable improvements in coding accuracy • Demonstrated experience in a highly matrixed, cross-functional environment • Bachelor's degree in Healthcare Administration, Business Administration, Finance, Public Health, or a related field

🏖️ Benefits

• Health insurance • 401(k) • Paid time off • Professional development opportunities