Medicare Risk Adjustment Manager

Job Summary

Managing a team remotely, the full-time salaried Medicare Risk Adjustment Manager will oversee strategy implementation for Medicare Risk Adjustment Programs, focusing on optimizing risk adjustment processes and enhancing revenue accuracy through data analysis.

Key responsibilities

• Oversee the end-to-end strategy for risk adjustment programs, managing provider workflows and ensuring accurate documentation
• Collaborate with actuarial and finance teams to support bid development and produce risk score projections and trend analysis
• Lead analysis and recommendations while managing employee performance and professional growth within the team

Required qualifications

• 8+ years of related work experience with strong risk adjustment experience in commercial and/or Medicare
• 3+ years of direct supervisory or management experience
• Bachelor's degree or equivalent related work experience
• Experience with statistical methodologies and risk adjustment, including SQL/SAS coding for quantitative analysis
• Advanced Excel skills and the ability to communicate complex information effectively