Director, Risk Adjustment & STAR Initiatives – Lead Strategy

L.A. Care; Los Angeles (CA); Vor Ort; USD 150.000 - 254.000; Vollzeit

Benefits dieser Stelle

PTO

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Zusammenfassung

L.A. Care Health Plan seeks a Director of Risk Adjustment Strategies and Initiatives in Los Angeles. This senior leader will design and drive enterprise risk adjustment programs, enhance diagnosis accuracy, and ensure compliant data collection across lines of business.

Responsibilities include vendor management, training, governance, and cross-functional collaboration with physicians and internal teams to optimize STAR performance and regulatory submissions.

Qualifikationen

• Bachelor's Degree in Business Administration or Healthcare Management or related field.
• In lieu of degree, equivalent education and/or experience may be considered.
• Master's Degree in Business Administration or Healthcare Management or related field (preferred).
• 8+ years in risk adjustment with CMS requirements.

Aufgaben

• Develop strategic plans for enterprise risk adjustment and STAR programs.
• Lead cross-functional initiatives to improve diagnosis accuracy, coding capture, and documentation quality.
• Oversee governance, workplans, timelines, and reporting for risk adjustment initiatives.
• Manage risk adjustment vendors, budgets, and external partnerships.
• Collaborate with analytics teams for data-driven opportunities and executive updates.
• Direct and develop staff, including hiring, coaching, and performance management.

Kenntnisse

Interpersonal skills

Written and verbal communication

Decision making

Data analysis

Risk adjustment operations

Cross-functional leadership

Adaptability

Leadership

Microsoft Office

Ausbildung

Bachelor's Degree in Business Administration or Healthcare Management

Master's Degree (Preferred)

Tools

Microsoft Office

Jobbeschreibung

L.A. Care Health Plan seeks a Director of Risk Adjustment Strategies and Initiatives in Los Angeles. This senior leader will design and drive enterprise risk adjustment programs, enhance diagnosis accuracy, and ensure compliant data collection across lines of business.

Responsibilities include vendor management, training, governance, and cross-functional collaboration with physicians and internal teams to optimize STAR performance and regulatory submissions.