Risk Adjustment Strategy Partner | Hybrid

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

Job summary

Intermountain Health in Murray, Utah is seeking a Risk Adjustment Strategic Partner to liaise between provider organizations and Select Health. This role coordinates risk adjustment, HEDIS, and STAR gap closure, with travel for in-person meetings as needed.

The position supports data-driven strategies to drive value-based care and outcomes improvement. The hybrid role involves collaboration with leadership, development of implementation plans, and ensuring compliant, effective risk adjustment

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 achieving goals and objectives.
• Excellent communication and interpersonal skills, with ability to build and maintain relationships with internal and external stakeholders.
• Intermediate Excel skills, PowerPoint (MS Suite).
• Demonstrated ability to present to large groups and internal leadership.
• Strong analytical skills and experience with data analysis and reporting.

Responsibilities

• Accountable for working with provider groups to achieve annual goals and engage for performance improvement.
• Develops strategies to address gaps in care and provides solutions for actionable clinic opportunities.
• Designs and implements reporting across the risk adjustment organization and with external partners.
• Supports HQRI strategic engagements, representing risk adjustment in new member initiatives and PPO strategies.
• Fosters relationships with providers and clinical leadership, internally and externally.
• Manages high-priority initiatives with proactive, self-guided leadership.
• Leads collaboration to coach provider partners in value-based contracts and risk adjustment strategies using data reports.
• Leads implementation of services in collaboration with Select Health team members and partnerships.
• Ensures clinics have interoperability with Select Health through data transfer and EMR access.

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, business administration, or equivalent work experience

Five years of experience in health plan and / or provider administration experience

Tools

Excel

PowerPoint

Job description

Intermountain Health in Murray, Utah is seeking a Risk Adjustment Strategic Partner to liaise between provider organizations and Select Health. This role coordinates risk adjustment, HEDIS, and STAR gap closure, with travel for in-person meetings as needed.

The position supports data-driven strategies to drive value-based care and outcomes improvement. The hybrid role involves collaboration with leadership, development of implementation plans, and ensuring compliant, effective risk adjustment