Palm Beach Accountable Care Organization · 20 hours ago
Senior Manager, Risk Adjustment
Palm Springs, FL
Full-time
Onsite
Senior Level
7+ years expPalm Beach Accountable Care Organization is seeking a Senior Manager, Risk Adjustment who will lead the risk adjustment strategy and operations to enhance compliance and revenue integrity. This role involves overseeing various initiatives, provider engagement, and analytics to ensure accurate risk capture across multiple lines of business.
Health CareInformation Technology
Responsibilities
Build and execute an annual risk adjustment plan aligned to growth, MLR, and revenue targets
Own program design for prospective, concurrent and retrospective workflows and implement best practice
Develop clinical opportunity(suspecting) strategies and partner with operations, analytics and finance on RAF forecasting
Prepare regular performance reports, recommendations, and executive level summaries
Serve as a primary point of contact for payor partners and external vendors on risk adjustment topics
Deliver educational content, toolkits, and resources to support improved provider engagement and documentation quality
Oversee chart acquisition for risk adjustment submissions
Qualification
Required
Deep knowledge of HCC models and submission processes
7-10+ years risk adjustment experience required
CPC, CRC, or CDEO certification required (preference for all)
Strong understanding of VBC financial methodologies (shared savings, risk adjustment)
Project management expertise
Exceptional communication and relationship-building skills with both internal teams and external partners
Ability to manage multiple priorities in a fast-paced environment
Proficiency in Excel, PowerPoint, and analytics/reporting tools
Knowledge of medical records work procedures
Knowledge of computer applications
Knowledge of medical terminology
Knowledge of legal and ethical consideration related to patient information
Ability to read and comprehend simple instructions, correspondence, and memos
Ability to write simple correspondence
Ability to effectively present information in one-on-one situations to visitors, clients, and other employees of the organization
Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions
MS Office Productivity Tools (Word, Excel, Outlook, PowerPoint)
High accuracy and extreme confidentiality a MUST
Detailed oriented and very organized
Ability to alphabetize and put information (materials, forms, etc.) into chronological order
Analyze medical records for completeness, schedule time and assignment effectively
Travel required within the defined region up to 25%, with travel to headquarters up to twice a year possible
Preferred
Bachelor's degree preferred
Experience in value-based care, payor-provider partnerships, population health, managed care, and/or ACO/CIN operations preferred
Company
Palm Beach Accountable Care Organization
Palm Beach Accountable Care Organization physicians have identified prevention as a key factor in improving overall patient health.
51-200 employees
H1B Sponsorship
Palm Beach Accountable Care Organization has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (2)
2024 (2)
2023 (2)
2021 (1)
2020 (2)
Funding
Current Stage
Growth StageLeadership Team
Amanda Larschan, MHA, PMP
Chief Data Officer
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