Strategic Risk Adjustment & Stars Program Manager

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

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k)

Paid time off

Employee Assistance Program

Job summary

Alpine Physician Partners is seeking a Program Manager, Risk Adjustment & Stars to bridge its technical teams with operations. You will coordinate risk adjustment cycles, manage timelines, and translate CMS methodologies into actionable plans for leadership and health plan partners.

You will supervise RAF score trends, align HCC capture workflows, and ensure compliant data submission. The role requires 5–7 years in Medicare Advantage or Stars quality, a PMI credential preferred, and strong

Qualifications

• Bachelor's degree in health informatics, data analytics, healthcare administration, business, or related field.
• 5–7 years of experience in Medicare Advantage risk adjustment and/or Star Ratings/quality improvement.
• CRC credential preferred and familiarity with value-based care programs.
• PMP or similar certification is a plus.

Responsibilities

• Owns the annual risk adjustment and Stars improvement program cycle, coordinating between technical teams and operational/business stakeholders.
• Builds and manages program timelines and throughput; reports progress to Alpine leadership and health plan partners.
• Leads cross-functional workgroups spanning coding/HCC teams, clinical quality, IT, and analytics; aligns technical work with operations.
• Manages program-level documentation and requirements; translates between technical specs and operational plans.
• Acts as liaison between coding/data teams and operational stakeholders on HCC capture workflows and gap identification.
• Monitors RAF score trends and translates findings into operational action plans.
• Coordinates data submissions accuracy and reconciliation (EDS) with deadlines.
• Tracks HCC model version transitions and communicates impact to leadership and business teams.
• Coordinates Star Ratings strategy across measures and ensures operational execution.
• Presents performance results and program recommendations to executive leadership and payer partners.

Skills

CMS HCC

RAF scoring

Cross-functional PM

Excel / SQL / BI

Education

Bachelor's degree in health informatics

Master's degree preferred

Tools

SQL

Tableau

Power BI

EDI data exchange

Job description

Alpine Physician Partners is seeking a Program Manager, Risk Adjustment & Stars to bridge its technical teams with operations. You will coordinate risk adjustment cycles, manage timelines, and translate CMS methodologies into actionable plans for leadership and health plan partners.

You will supervise RAF score trends, align HCC capture workflows, and ensure compliant data submission. The role requires 5–7 years in Medicare Advantage or Stars quality, a PMI credential preferred, and strong