Vice President of Risk Adjustment

Job Summary

A company is looking for a Vice President of Risk Adjustment Program Operations & Data Integrity.

Key Responsibilities

• Provide operational leadership for Risk Adjustment program operations and oversee compliance with data integrity and validation audits
• Lead and develop multi-disciplinary teams while driving enterprise change management through standardized processes
• Ensure accurate encounter data submissions and establish governance for Risk Adjustment compliance and audits

Required Qualifications

• Bachelor's degree in health information management, Nursing, Healthcare Administration, Business, or related field; advanced degree preferred
• 10+ years of progressive leadership experience in Risk Adjustment, medical coding, or healthcare compliance
• Experience leading large teams of certified coders and auditors across multiple programs
• Deep knowledge of CMS Risk Adjustment requirements and ICD 10 CM coding standards
• Proven record of establishing coding governance and audit readiness programs in regulated environments