Risk Adjustment Strategy Lead

L.E. Cox Medical Centers; Springfield (MO); On-site; USD 85,000 - 120,000; Full time

Job summary

Cox HealthPlans seeks a manager to lead risk adjustment programs, ensuring alignment of revenue with member health status and compliance with regulations. You will partner with CHP leaders to design and implement analytic strategies across financial and operational domains.

The role requires a bachelor’s degree in accounting/related field or 8+ years of relevant experience, with strong detail orientation and proven communication skills to coordinate across teams.

Qualifications

• Bachelor’s degree in Accounting, Finance, Business, or related field OR 8 years of relevant experience.
• At least 5 years of experience in accounting/finance, public health, health administration, health insurance or health-related field.
• Preferred: Experience with risk adjustment program, government programs compliance, managed care.
• Attention to detail and self-starter.
• Knowledge of governmental & other regulatory standards, requirements, & guidelines related to risk adjustment and compliance.
• Knowledge of personal computers and software; knowledge of statistics preferred.

Responsibilities

• Manage and coordinate the risk adjustment programs for Cox HealthPlans (CHP).
• Work with staff and leaders to ensure risk-adjusted revenue matches members health status.
• Develop, designs and executes risk adjustment operational strategies and processes.
• Ensure compliance with all policies and risk adjustment regulations.
• Provide analytics to leadership and others to inform decisions.

Skills

Attention to detail

Regulatory compliance

Risk adjustment

Microsoft Excel

Strong communication

Education

Bachelor's degree in Accounting

Finance or related field

8 years relevant experience

Tools

Risk adjustment software

Healthcare analytics tools

Job description

Cox HealthPlans seeks a manager to lead risk adjustment programs, ensuring alignment of revenue with member health status and compliance with regulations. You will partner with CHP leaders to design and implement analytic strategies across financial and operational domains.

The role requires a bachelor’s degree in accounting/related field or 8+ years of relevant experience, with strong detail orientation and proven communication skills to coordinate across teams.