Stars & Risk Adjustment Program Manager

Alpine Physician Partners; California City (CA); Remote; USD 84,000 - 120,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k)

Paid time off (PTO)

Employee Assistance Program (EAP)

Job summary

Alpine Physician Partners is seeking a Program Manager, Risk Adjustment & Stars, to bridge CMS/HCC knowledge with operational execution across coding, analytics, and health plan operations.

You will own the annual risk adjustment and Stars improvement cycle, coordinate cross-functional teams, monitor RAF trends, and translate technical findings into actionable business plans for leadership and partners. Experience in Medicare Advantage and value-based care is preferred.

Qualifications

• Bachelor's degree in health informatics, data analytics, healthcare administration, business, or related field; Master’s preferred.
• Five to seven years of Medicare Advantage risk adjustment and/or Star Ratings experience.
• CRC and PMP certifications preferred.
• Experience with value-based care, ACOs, or delegated risk arrangements.
• Familiarity with health plan Stars/quality programs and data exchange requirements.
• Strong project management and cross-functional collaboration skills.

Responsibilities

• Owns the risk adjustment and Stars program cycle, coordinating technical and operational teams.
• Reports progress to leadership in clear, business terms.
• Leads cross-functional workgroups across coding, quality, IT and analytics.
• Translates CMS changes into actionable operational plans.
• Manage RAF trend monitoring and action planning with analytics teams.
• Ensure compliance with CMS regulations and RADV readiness.

Skills

CMS HCC risk adjustment

RAF score methodology

Cross-functional collaboration

Excel

SQL

Tableau/Power BI

Communication skills

Project management

Education

Bachelor's degree in health informatics, data analytics, healthcare administration, business, or related field

Master's degree preferred

Tools

Tableau

Power BI

SQL

Excel

Job description

Alpine Physician Partners is seeking a Program Manager, Risk Adjustment & Stars, to bridge CMS/HCC knowledge with operational execution across coding, analytics, and health plan operations.

You will own the annual risk adjustment and Stars improvement cycle, coordinate cross-functional teams, monitor RAF trends, and translate technical findings into actionable business plans for leadership and partners. Experience in Medicare Advantage and value-based care is preferred.