Hybrid Risk Adjustment Strategist & Provider Partnerships

Intermountain Healthcare Inc.; Murray (UT); Hybrid; USD 62,000 - 96,000; Full time

Benefits offered by this job

Hybrid work model

Travel for meetings

Benefits package

Job summary

Intermountain Health in Murray, Utah seeks a Risk Adjustment Strategic Partner to liaise with provider organizations, lead risk adjustment initiatives, and drive HEDIS/STAR gap closure. Travel for in-person meetings with provider organizations is required as part of a hybrid role with mostly remote work.

You will develop implementation plans, analyze health data, and advise executives on segment-specific strategies, collaborating with leadership to craft value-based programs and KPI reporting.

Qualifications

• Proficient at risk adjustment strategy for Medicare and ACA lines, including RAF score calculations and ROI on engagement strategies.
• Demonstrated understanding of HEDIS and STAR measures.
• Knowledge of healthcare regulations and compliance requirements.
• Familiarity with value-based care, provider incentive programs, P4P and quality programs.
• Demonstrated ability to manage projects and teams with a focus on goals.

Responsibilities

• Accountable for working with provider groups to achieve annual goals and engage for performance improvement.
• Develops strategies to address gaps in care and monitor program effectiveness.
• Designs and implements reporting across risk adjustment org. and external partners.
• Supports HQRI engagements and PPO strategies.
• Fosters relationships with providers and clinical leadership.
• Manages high-priority initiatives with proactive leadership.
• Collaborates to coach providers on value-based contracts and data usage.
• Leads operational strategies with Select Health partners and internal teams.
• Ensures clinics have interoperable data transfer and EMR access.
• Coordinates resolution of issues between clinics and Select Health.
• Identifies and implements risk adjustment initiatives aligned with org goals.
• Ensures compliance with regulatory requirements and best practices.
• Manages vendor relationships supporting risk adjustment activities.
• Reports monthly KPIs to leadership for specific groups and regions.

Skills

Risk Adjustment

Relationship Building

Performance Improvements

Management Reporting

Quality Measurements

Data Interpretations

Analytical Thinking

Written Communication

HEDIS

Accountability

Data Reporting

Presentations

Education

Bachelor’s degree in healthcare administration or business administration

Tools

Excel

PowerPoint

Job description

Intermountain Health in Murray, Utah seeks a Risk Adjustment Strategic Partner to liaise with provider organizations, lead risk adjustment initiatives, and drive HEDIS/STAR gap closure. Travel for in-person meetings with provider organizations is required as part of a hybrid role with mostly remote work.

You will develop implementation plans, analyze health data, and advise executives on segment-specific strategies, collaborating with leadership to craft value-based programs and KPI reporting.