Director of Risk Adjustment

Village Care•New York, NY

3d•$153,979 - $173,226•Remote

About The Position

Join VillageCare in New York City as a Full-Time Director of Risk Adjustment and take your career to the next level while making a meaningful impact in the health care industry. This role offers the flexibility to work from home, allowing you to balance personal and professional commitments seamlessly. You will lead innovative strategies aimed at enhancing patient care while significantly influencing risk management practices. With a competitive salary range of $153,978.55 - $173,225.87, this position not only rewards your expertise but also aligns with your drive for excellence and customer-centricity. Our high-performance culture encourages problem-solving and forward-thinking, ensuring you thrive in a supportive environment. You will be provided great benefits such as PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b), Life & Disability, Commuter Benefits, Paid Family Leave, and Additional Employee Discounts. If you are ready to contribute to an organization committed to integrity and excellence, apply today and be part of a dynamic team shaping the future of health care. VillageCare: Our Mission VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. Your day as a Director of Risk Adjustment The Director of Risk Adjustment at VillageCare plays a pivotal role in enhancing the quality of care delivered to our members in New York City. This position focuses on developing and executing a comprehensive annual Risk Adjustment strategy that ensures reimbursements accurately reflect our members' clinical diagnoses. As the leader of the risk adjustment team, you will coordinate internal and external resources to drive initiatives forward while serving as the subject matter expert for business processes and systems. A key responsibility involves creating an annual Provider Risk Adjustment strategy aimed at improving diagnosis coding accuracy through education and engagement with incentive models. This role also includes assessing strategic performance metrics to support business initiatives and overseeing vendor operations related to risk adjustments. Additionally, you will manage a team of risk adjustment coders, ensuring strict compliance with RADV and other regulatory protocols, ensuring the highest standards of care and accuracy.

Requirements

Minimum 8 years of relevant professional work experience
Experience in healthcare plan - Medicare Advantage experience preferred
Risk adjustment knowledge and expertise in Medicare Advantage products
Leadership experience including staff and process management experience
Capacity to multi-task at high detail-oriented level
Strong communication skills (verbal, written presentation interpersonal)
Strong analytical and logical skills paired with strong attention to detail
Bachelor's degree in Healthcare, Finance or relevant field or equivalent years of experience required

Responsibilities

Developing and executing a comprehensive annual Risk Adjustment strategy
Coordinating internal and external resources to drive initiatives forward
Serving as the subject matter expert for business processes and systems
Creating an annual Provider Risk Adjustment strategy aimed at improving diagnosis coding accuracy through education and engagement with incentive models
Assessing strategic performance metrics to support business initiatives
Overseeing vendor operations related to risk adjustments
Managing a team of risk adjustment coders
Ensuring strict compliance with RADV and other regulatory protocols