Strategic Program Manager - Risk Adjustment & Stars

Phpmcs; Denver, Northern (CO, KY); Hybrid; USD 84,000 - 120,000; Full time

Benefits offered by this job

Salary range benefits

Job summary

Alpine is seeking a Program Manager, Risk Adjustment & Stars, to bridge coding, data, analytics and operations for Medicare risk adjustment and Star Ratings improvements.

You will coordinate across teams, manage timelines and communicate progress to leadership and health plan partners, ensuring alignment with CMS guidelines and business goals. This role emphasizes collaboration and technical-to-operational translation.

Qualifications

• Bachelor's degree in health informatics, data analytics or related field (Master's preferred).
• 5–7 years of Medicare Advantage risk adjustment/Star Ratings experience, preferably in a value-based care setting.
• CRC certification preferred; PMP or similar certification helpful.

Responsibilities

• Owns the annual risk adjustment and Stars improvement program cycle, coordinating across technical and operational teams.
• Leads cross-functional workgroups spanning coding, quality, IT, and analytics; aligns technical work with business priorities.
• Monitors RAF score trends and translates findings into operational action plans.
• Ensures CMS regulations and compliance; supports RADV audit readiness and data validation requests.

Skills

Project management

Communication

Data analysis

Cross-functional collaboration

Excel

SQL

Tableau/Power BI

CMS HCC knowledge

Risk adjustment

Travel

Education

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

Master's degree preferred

Tools

Tableau

Power BI

Excel

EDS submission systems

Job description

Alpine is seeking a Program Manager, Risk Adjustment & Stars, to bridge coding, data, analytics and operations for Medicare risk adjustment and Star Ratings improvements.

You will coordinate across teams, manage timelines and communicate progress to leadership and health plan partners, ensuring alignment with CMS guidelines and business goals. This role emphasizes collaboration and technical-to-operational translation.