Senior AVP, Medicare RAF Performance

Alignment Health; Northern (KY); Hybrid; USD 198,000 - 297,000; Full time

Job summary

Alignment Health seeks an executive to lead Medicare Risk Adjustment performance across markets, directing RAF strategies and operational outcomes. You will oversee chart retrieval, coding, analytics and vendor partnerships to ensure revenue realization and audit readiness.

The role requires extensive experience in managed care, healthcare analytics, and leadership, collaborating with finance, compliance, and market operations to achieve annual targets and long-term growth.

Qualifications

• Ten+ years in managed care, analytics, or risk adjustment leading enterprise programs.
• Strong collaboration with executive leadership and cross-functional teams.

Responsibilities

• Lead annual RAF performance plan with market execution and resources.
• Oversee chart retrieval, coding production and submission performance.
• Drive provider engagement and vendor partnerships to meet RAF targets.
• Ensure audit readiness and revenue realization through analytics and reporting.

Skills

Risk adjustment

Healthcare analytics

Executive leadership

Forecasting

Provider engagement

Vendor management

Data governance

SQL knowledge

Education

Bachelor’s degree in healthcare/business/analytics/information systems

Tools

Excel

SQL

Job description

Alignment Health seeks an executive to lead Medicare Risk Adjustment performance across markets, directing RAF strategies and operational outcomes. You will oversee chart retrieval, coding, analytics and vendor partnerships to ensure revenue realization and audit readiness.

The role requires extensive experience in managed care, healthcare analytics, and leadership, collaborating with finance, compliance, and market operations to achieve annual targets and long-term growth.