California Licensed Risk Adjustment Director

Job Summary

A company is looking for a Risk Adjustment Director to lead the Risk Adjustment Department.

Key Responsibilities

• Provide strategic management oversight for the Risk Adjustment Department functions
• Act as a subject matter expert and provide executive-level guidance on coding and risk adjustment methodologies
• Direct, manage, and supervise the Risk Adjustment Department staff

Required Qualifications, Training, and Education

• Bachelor's degree in Finance, Business, Healthcare Administration, Mathematics, Statistics, or a closely related field
• A minimum of ten years of experience in healthcare finance or analytics, including five years with Medicare risk adjustment processes
• At least two years of experience related to Medicare Managed Care Programs
• A minimum of three years of supervisory experience
• Strong knowledge of managed care industry and Medicare health insurance payment methodologies