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VillageCare · 2 weeks ago

Director of Risk Adjustment

New York, NY

Full-time

Hybrid

Director/Executive

$154K/yr - $173K/yr

8+ years exp

VillageCare is a community-based, not-for-profit organization dedicated to serving individuals with chronic care needs. The Director of Risk Adjustment will lead the development and execution of a comprehensive Risk Adjustment strategy to enhance patient care and ensure accurate reimbursements reflecting clinical diagnoses.

Health CareHospitalNon Profit

Responsibilities

Develop and execute a comprehensive annual Risk Adjustment strategy that ensures reimbursements accurately reflect our members' clinical diagnoses

Coordinate internal and external resources to drive initiatives forward while serving as the subject matter expert for business processes and systems

Create an annual Provider Risk Adjustment strategy aimed at improving diagnosis coding accuracy through education and engagement with incentive models

Assess strategic performance metrics to support business initiatives and oversee vendor operations related to risk adjustments

Manage a team of risk adjustment coders, ensuring strict compliance with RADV and other regulatory protocols

Qualification

Medicare Advantage experienceRisk adjustment expertiseLeadership experienceHealthcare knowledgeAnalytical skillsMulti-tasking abilityProcess managementCommunication skillsAttention to detail