Director of Burden of Illness Strategy & Operations

verawholehealth; Florida; On-site; USD 137,000 - 206,000; Full time

Job summary

The Director at verawholehealth develops and leads strategies to ensure accurate and complete representation of patient disease burden through compliant clinical documentation and risk adjustment practices.

This role uses data and performance trends to identify opportunities, establish organizational and practice-level priorities, and develop programs that improve documentation, coding accuracy, condition recapture, prevalence, and overall value-based care outcomes.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Health Information Management, or Public Health.
• CRC or CPC certification preferred.
• 7+ years in Medicare Risk Adjustment, Burden of Illness, population health, or related healthcare operations.
• 3-5 years of leadership experience.
• Strong CMS-HCC methodologies and reporting experience.
• Experience with physician practices and provider leadership.
• Experience with Medicare Advantage and value-based care arrangements.
• Experience with Excel, SQL, Tableau or Power BI for analytics.

Responsibilities

• Provide leadership for Burden of Illness initiatives.
• Maintain knowledge of CMS-HCC methodologies and guidelines.
• Monitor key BOI indicators and identify opportunities.
• Educate providers on documentation and coding improvements.
• Set BOI priorities based on performance data.
• Develop scalable workflows integrating BOI activities into practice operations.
• Coordinate BOI initiatives across Risk Adjustment, Population Health, and Operations.
• Track BOI performance and intervene as needed.
• Lead cross-functional teams to execute prioritized BOI initiatives.

Skills

Risk Adjustment

Burden of Illness

Data analysis

Executive communication

Leadership

Education

Bachelor's degree in Healthcare Administration or related

CRC or CPC certification

Tools

Excel

SQL

Tableau

Power BI

Job description

The Director at verawholehealth develops and leads strategies to ensure accurate and complete representation of patient disease burden through compliant clinical documentation and risk adjustment practices.

This role uses data and performance trends to identify opportunities, establish organizational and practice-level priorities, and develop programs that improve documentation, coding accuracy, condition recapture, prevalence, and overall value-based care outcomes.