Hybrid Risk Adjustment Strategy Lead

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

Benefits offered by this job

Hybrid work option

Professional development

PEAK education program

Comprehensive benefits

Job summary

Intermountain Health is seeking a Risk Adjustment Strategic Partner to serve as a liaison between provider groups and Select Health. You will lead risk adjustment initiatives, analyze healthcare data, and develop programs that close care gaps while guiding executives on segment strategies.

The role requires collaboration with leadership, independence in problem solving, and the ability to navigate Medicare and ACA RAF calculations, with occasional travel for in-person meetings.

Qualifications

• Proficient in risk adjustment strategy for Medicare and ACA lines, including RAF calculations and ROI on engagement.
• Solid understanding of HEDIS and STAR measures.
• Knowledge of healthcare regulations and compliance requirements.
• Familiarity with value-based care and provider incentive programs.
• Ability to manage projects and teams to reach goals.
• Excellent communication and interpersonal skills.
• Intermediate Excel and PowerPoint skills.
• Ability to present to large groups and leadership.
• Strong analytical skills and data reporting experience.

Responsibilities

• Engage provider groups to meet annual goals and drive performance improvement.
• Develop strategies to close gaps in care and monitor program effectiveness.
• Design and implement risk-adjustment reporting with internal and external partners.
• Support HQRI engagements and PPO strategies.
• Foster relationships with providers and clinical leadership.
• Lead high-priority initiatives with proactive leadership.
• Coach provider partners in value-based contracts and data-driven decision making.
• Collaborate to implement risk-adjustment initiatives aligned with organizational goals.
• Ensure regulatory compliance and manage vendor relationships.
• Report monthly KPIs to Select Health leadership.

Skills

Risk Adjustment

HEDIS

STAR measures

Data Reporting

Relationship Building

Performance Improvements

Management Reporting

Presentations

Education

Bachelor’s degree in healthcare administration, business administration, or equivalent work experience

Five years of health plan/provider administration experience

Tools

Excel

PowerPoint

Job description

Intermountain Health is seeking a Risk Adjustment Strategic Partner to serve as a liaison between provider groups and Select Health. You will lead risk adjustment initiatives, analyze healthcare data, and develop programs that close care gaps while guiding executives on segment strategies.

The role requires collaboration with leadership, independence in problem solving, and the ability to navigate Medicare and ACA RAF calculations, with occasional travel for in-person meetings.