VP, Risk Adjustment Performance
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Job Description
Vice President leading Risk Adjustment strategy for Alignment Health's Medicare Advantage programs. Driving performance, compliance, and team development for revenue optimization in senior healthcare.
Responsibilities:
- 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
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