Executive Leader, Medicare Risk Adjustment Performance

E2E Alignment Healthcare USA, LLC; California (MO); On-site; USD 198,000 - 297,000; Full time

Job summary

Alignment Health is seeking an Executive leader to drive Medicare Risk Adjustment performance across markets. You will shape enterprise strategies, supervise chart retrieval, coding, and submission readiness, and partner with Finance, Network Management and Vendors to meet RAF targets.

The role requires strong experience in risk adjustment, analytics, and leadership, with a focus on audit readiness and revenue integrity. Collaboration across teams is essential.

Qualifications

• Ten or more years in managed care, Medicare Advantage, or risk adjustment.
• Experience leading enterprise risk adjustment programs across markets.
• Strong knowledge of CMS-HCC methodologies and analytics.

Responsibilities

• Lead annual RAF performance and enterprise risk adjustment strategy.
• Oversee chart retrieval, coding production, and submission readiness.
• Manage provider engagement, vendor partnerships, and accuracy improvements.
• Provide executive reporting on RAF performance, risks and opportunities.

Skills

Risk Adjustment

Leadership

Healthcare Analytics

Budgeting/Forecasting

Education

Bachelor’s degree in healthcare/business/related field

Advanced degree preferred

Tools

Excel

SQL

Job description

Alignment Health is seeking an Executive leader to drive Medicare Risk Adjustment performance across markets. You will shape enterprise strategies, supervise chart retrieval, coding, and submission readiness, and partner with Finance, Network Management and Vendors to meet RAF targets.

The role requires strong experience in risk adjustment, analytics, and leadership, with a focus on audit readiness and revenue integrity. Collaboration across teams is essential.