Tennessee Licensed Risk Adjustment Director

Job Summary

To enhance risk adjustment operational improvement, the full-time Tennessee Licensed Risk Adjustment Director will manage governance, monitoring, and controls of risk adjustment tools, ensuring accurate data handling and CMS submission while working remotely from anywhere within the U.S.

Key responsibilities

• Assess and enhance risk adjustment tools and workflows to ensure accurate diagnosis code presentation and submission
• Monitor and oversee diagnosis code collection and submission controls to prevent data leakage or inaccuracies
• Collaborate with cross-functional teams to resolve potential data issues and implement remediation plans as necessary

Required qualifications

• 5+ years of risk adjustment managed care experience
• Technical experience in Microsoft programs such as Excel