CPC Licensed VP of Risk Adjustment

Job Summary

Leading the strategy and execution of Risk Adjustment programs, the full-time remote CPC Licensed VP of Risk Adjustment will oversee the optimization of Medicare Advantage initiatives, ensuring compliance and enhancing provider engagement to improve coding accuracy and program performance.

Key responsibilities:

• Develop and execute a multi-year Risk Adjustment business plan to improve RAF accuracy and revenue optimization
• Lead provider engagement strategies to enhance HCC coding accuracy and clinical documentation quality
• Build and manage a high-performing Risk Adjustment team, fostering a culture of accountability and continuous improvement

Required qualifications:

• Minimum 15 years of leadership experience in Medicare Advantage with a focus on Risk Adjustment
• Proven experience developing multi-year Risk Adjustment business plans in a health plan or managed care organization
• Expert knowledge of HCC coding and CMS Risk Adjustment regulations
• Demonstrated ability to lead provider engagement strategies that improve coding accuracy
• Experience in a matrixed, cross-functional environment with a track record of driving aligned execution