Manager, Risk Adjustment, Provider Partnerships
Core
Lead strategy and execution of provider-facing risk adjustment initiatives, managing cross-functional program delivery and provider engagement to improve documentation and coding outcomes.
Role type
Manager, Risk Adjustment Provider Partnerships
Builds
Provider engagement programs, risk adjustment operational models, and performance improvement strategies
Domain
Health insurance / Risk adjustment / Provider contracting
Deliverable
dashboards & analysis
Required skills
Program management, strategic planning, provider partnerships, health-plan operations, risk adjustment, contracting, data analysis, stakeholder management
Preferred skills
Risk adjustment in health plan/consulting, provider contracting, value-based care, SQL/BigQuery, Lean/Six Sigma
Responsibilities
Lead end-to-end strategy and management of Risk Adjustment Provider Partnerships program; Partner with Network, Market, Legal, and Data Science teams to integrate RA requirements into provider agreements; Establish and maintain operational relationships with provider organizations; Analyze provider performance and documentation trends to develop improvement plans; Lead cross-functional implementation of provider-specific interventions; Develop scalable provider education and incentive approaches
Seniority
Manager, hands-on IC
