Emergent Holdings · 21 hours ago
Manager, Risk Adjustment
United States
Full-time
Remote
Mid, Senior Level
$92K/yr - $154K/yr
7+ years expEmergent Holdings is a company focused on healthcare management, and they are seeking a Manager for Risk Adjustment. This role involves directing activities within the business unit, managing staff, and developing strategies to support continuous quality improvement and operational efficiency.
Health CareInformation ServicesInformation TechnologyInsuranceMedical
Responsibilities
Responsible for managing large scale, current and multi-year plan strategy development in a dynamic and evolving environment
Manage and continuously improve end-to-end process model operations
Oversee data driven performance management of processes, programs, vendors, staff and providers. Conduct operations in a planned, metric-driven approach
Provide leadership, planning, project coordination and management for the development of a cost-effective department while concurrently facilitating efficient operations to meet current and future business needs within the organization
Participate in the development of programs as a strategic partner that supports the company plan
Participate in development of annual departmental budget, monitor budget and identify budget discrepancies. Research cause and make recommendations
Responsibility for balancing workload to optimize the effectiveness of the department
Implement data quality controls. Conduct reasonableness checks and validate data
Present data to different audiences. Look at existing views of data presentation and create improved views. Seek to understand and explain data trends by doing deeper analysis
Interpret data and write insights to explain performance and assist leaders in decision making
Continuous improvement mindset to continuously look for more efficient ways to present information, create report deliverables, etc
Manage activities of a department including but not limited to planning, problem solving, staff development and communication
Execute function/area objectives that support continuous improvement
Manage professional employees. Responsible for special projects and/or problem resolutions
Provide effective and efficient solutions to complex business problems. Provide high level oversight and leadership
Qualification
Required
Bachelor's Degree in related field required
Seven years of progressively more responsible experience in a healthcare environment with demonstrated technical experience that provides the necessary knowledge, skills and abilities
Three years of leadership experience in healthcare management required
Must demonstrate leadership ability and team building skills to effectively supervise professional and non-professional staff and interact with all levels of management
Ability to work with and empower others on a collaborative basis to ensure success of unit team
Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions and employing active listening techniques
Ability to effectively present budgetary and/or cost information, and respond to questions as appropriate
Ability to establish workflows, manages multiple projects, and meets necessary deadlines
Ability to work under general direction
Ability to work effectively in a team environment
Good analytical, organizational, planning, verbal and written communication skills
Strong technical business writing skills
Act with sense of urgency
Ability to know when to bring focus and attention to issues
Ability to appropriately package current state analysis and present to leaders/executives
Knowledge of impact analysis and financial risk adjustment impact analysis
Ability to manage multiple points of integration between internal systems and vendors
Strong Power Point and Excel skills
Database skills, including SAS, SQL and Access are strong enough to lead a team that regularly utilizes these tools
Extensive experience and knowledge of health insurance and risk adjustment
Knowledge of Medicare Advantage, CMS and HHS regulations
Preferred
Master's Degree in related field considered a plus
Experience in risk adjustment implementing new risk adjustment programs for Medicare Advantage or Medicaid products preferred
Certification or progress toward certification is highly preferred and encouraged
Company
Emergent Holdings
Emergent Holdings’ elite team makes lives, companies and communities better! Emergent Holdings is driven by a singular goal — improving the health and safety of our customers and our communities.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
John S. Roberts
Executive Vice President, Emerging Markets & Chief Administrative Officer
Brittanie Benson
Human Resources Business Partner
Recent News
Thailand Business News
2025-06-21
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