Strategic Risk Adjustment & Stars Program Lead

Alpine Physician Partners; Denver (CO); Hybrid; USD 84,000 - 120,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401(k)

PTO

EAP

Job summary

Alpine Physician Partners in Denver, CO is seeking a Program Manager, Risk Adjustment & Stars to bridge coding, analytics, IT, and operations. You will own the annual risk adjustment and Stars program, coordinate across teams, and translate CMS methodology into actionable plans.

The role requires 5–7 years in Medicare Advantage risk adjustment or Stars/quality improvement, a health informatics or related degree, and credentials such as CRC or PMP are preferred. Travel may be required.

Qualifications

• Five (5) to seven (7) years of experience in Medicare Advantage risk adjustment and/or Star Ratings/quality improvement.
• Bachelor’s degree in a related field; Master’s preferred.
• CRC credential and PMP or similar certification are a plus.
• Experience with value-based care, ACOs, or delegated risk arrangements is desirable.
• Familiarity with multiple health plan Stars/quality programs and data exchange requirements.

Responsibilities

• Owns the annual risk adjustment and Stars improvement program cycle with cross-functional stakeholders.
• Builds and manages program timelines; reports progress to leadership and partners.
• Leads cross-functional workgroups across coding, quality, IT, and analytics.
• Manages documentation and requirements, translating between technical specs and operations.
• Acts as liaison on HCC capture workflows and gap identification with vendors.
• Monitors RAF scores and translates findings into operational actions.
• Coordinates data submission accuracy and reconciliation with timelines.
• Presents performance results and recommendations to leadership.

Skills

CMS HCC risk adjustment models

RAF score methodology

EDS submission processes

Star Ratings measure specifications

Cross-functional collaboration

Project management

Excel proficiency

SQL

Tableau

Power BI

Travel willingness

Communication skills

Education

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

Master's degree preferred

Tools

Excel

SQL

Tableau

Power BI

Job description

Alpine Physician Partners in Denver, CO is seeking a Program Manager, Risk Adjustment & Stars to bridge coding, analytics, IT, and operations. You will own the annual risk adjustment and Stars program, coordinate across teams, and translate CMS methodology into actionable plans.

The role requires 5–7 years in Medicare Advantage risk adjustment or Stars/quality improvement, a health informatics or related degree, and credentials such as CRC or PMP are preferred. Travel may be required.