Director, Risk Adjustment

Ladders; United States; Remote; USD 127,000 - 216,000; Full time

Benefits offered by this job

Comprehensive health insurance options

Retirement savings plan with employer

Job summary

Ladders is seeking a Director of Risk Adjustment to own enterprise-wide risk adjustment strategy, governance, and execution across healthcare operations. The leader will drive coding, analytics, education, and audit readiness while partnering with internal teams and external vendors for scalable processes.

Location: Remote - US-based candidates only. Compensation ranges from $127,338 to $216,474 annually, with opportunities to drive improvements in health outcomes and operational quality.

Qualifications

• 5+ years in healthcare, including 3+ years in risk adjustment and team management.
• Deep knowledge of risk adjustment strategies and data submission guidelines.
• Experience managing vendor relationships and familiarity with pricing models.
• Preferred experience in Medicaid, Medicare, and Commercial health plan operations.
• Bachelor's degree required; advanced degree preferred in health-related field, mathematics, or statistics.

Responsibilities

• Establish and maintain the enterprise risk adjustment strategy and governance framework.
• Develop scalable engagement and education programs for continuous quality improvement.
• Support member engagement strategies to enhance health outcomes.
• Oversee risk adjustment processes and collaborate on annual education strategies.
• Lead risk adjustment analytic functions, including monitoring and reporting.
• Ensure audit readiness for internal and external audits, overseeing documentation standards.
• Manage risk adjustment coding functions and operational workflows.

Skills

Risk adjustment knowledge

Team leadership

Vendor management

Analytics

Education program development

Education

Bachelor's degree

Advanced degree preferred (health/math/statistics)

Job description

For our client, we are seeking a Director, Risk Adjustment to join the team of a leader in the Finance & Insurance space.

This role will own enterprise-wide risk adjustment strategy, governance, and execution across healthcare operations. The Director will lead cross-functional efforts to strengthen coding, analytics, education, audit readiness, and member engagement in support of improved health outcomes and operational quality. This position also partners with internal teams and external vendors to advance scalable processes, ensure compliant data submission, and support continuous improvement across the organization.

Location: Remote - US based candidates only, no visa sponsorship available

Compensation: $127,338 - $216,474 annually

Responsibilities

• Establish and maintain the enterprise risk adjustment strategy and governance framework
• Develop scalable engagement and education programs for continuous quality improvement
• Support member engagement strategies to enhance health outcomes
• Oversee risk adjustment processes and collaborate on annual education strategies
• Lead risk adjustment analytic functions, including monitoring and reporting
• Ensure audit readiness for internal and external audits, overseeing documentation standards
• Manage risk adjustment coding functions and operational workflows

Qualifications

• 5+ years of healthcare experience, including 3+ years in risk adjustment and team management
• Deep knowledge of risk adjustment strategies and data submission guidelines
• Experience managing vendor relationships and familiarity with pricing models
• Preferred experience in Medicaid, Medicare, and Commercial health plan operations
• Bachelor's degree required; advanced degree preferred in a health-related field, mathematics, or statistics

Benefits

• Comprehensive health insurance options
• Retirement savings plan with employer match
• Professional development opportunities and training
• Flexible work environment with remote options
• Paid time off and holiday leave

Our client is an equal opportunity employer.