Senior Risk Adjustment Strategy Partner

Intermountain Healthcare Inc.; Frankfort (KY); Ibrido; USD 62.000 - 96.000; Tempo pieno

Vantaggi offerti da questo lavoro

Benefits package

Descrizione del lavoro

SelectHealth - Murray in Murray, Utah is seeking a Risk Adjustment Strategic Partner. This hybrid, mostly remote role involves leading data-driven risk adjustment initiatives, coordinating workstreams for HEDIS/STAR gap closure, and engaging provider organizations with data-driven strategies.

Travel to local clinics is required quarterly. You will craft implementation plans, monitor program performance, and advise executives on population health strategies.

Competenze

• Proficient in risk adjustment strategy for Medicare and ACA lines, including RAF score calculations.
• Solid 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.
• Strong project and team management with goal orientation.
• Excellent communication and interpersonal skills for stakeholders.
• Intermediate Excel and MS PowerPoint skills.
• Ability to present to large groups and leadership.
• Strong data analysis and reporting capabilities.

Mansioni

• Collaborate with provider groups to meet annual goals and engage for 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 strategic engagements and new member initiatives.
• Foster relationships with providers and clinical leadership.
• Lead high-priority initiatives with proactive leadership.
• Coach provider partners on value-based contracts and data-informed decisions.
• Coordinate implementation of services with the Select Health team.
• Ensure clinic interoperability and efficient resource use.
• Resolve issues between clinics and Select Health.
• Identify and implement risk adjustment initiatives aligned with goals.
• Ensure compliance with regulations and best practices.
• Manage vendor relationships supporting risk adjustment.
• Report monthly KPIs to leadership for groups and regions.

Conoscenze

Risk Adjustment

Relationship Building

Performance Improvements

Management Reporting

Quality Measurements

Data Interpretations

Analytical Thinking

Written Communication

HEDIS

Accountability

Data Reporting

Presentations

Formazione

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

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

Strumenti

Excel

PowerPoint

Descrizione del lavoro

SelectHealth - Murray in Murray, Utah is seeking a Risk Adjustment Strategic Partner. This hybrid, mostly remote role involves leading data-driven risk adjustment initiatives, coordinating workstreams for HEDIS/STAR gap closure, and engaging provider organizations with data-driven strategies.

Travel to local clinics is required quarterly. You will craft implementation plans, monitor program performance, and advise executives on population health strategies.