Executive Lead, Medicare Risk Adjustment Performance

alignmenthealthcare

United States

On-site

USD 180,000 - 250,000

Full time

5 days ago

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Job summary

Alignment Health is seeking an accomplished executive to lead Medicare Risk Adjustment Performance as AVP, guiding enterprise RAF strategy and operations across markets. You will work with Market Operations, Network Management, Finance and Data teams to hit annual RAF targets and support audit readiness.

The role drives prospective, concurrent and retrospective risk adjustment programs, oversees chart retrieval and coding production, and mentors provider engagement and vendor partnerships to

Qualifications

Proven leadership of enterprise risk adjustment programs.
Experience driving RAF performance and market execution.
Strong analytical, reporting, and vendor-management capabilities.

Responsibilities

Lead annual operating plan for Medicare risk adjustment performance with multi-market execution.
Oversee prospective, concurrent and retrospective risk adjustment initiatives and chart activities.
Set performance guidelines, report to senior leadership, and drive action-oriented reviews.
Manage vendor partnerships, contracts, and service delivery for risk adjustment.
Develop scalable reporting and analytics to improve audit readiness and visibility.

Skills

Strategic leadership

Executive communication

Data analytics

Cross-functional collaboration

Healthcare industry knowledge

Education

Bachelor's degree in Health Administration, Business, or related field

Job description

The role drives prospective, concurrent and retrospective risk adjustment programs, oversees chart retrieval and coding production, and mentors provider engagement and vendor partnerships to

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