Director, Risk Adjustment
About The Position
Town Square Health is seeking a Director, Risk Adjustment to build and lead our end-to-end strategy for accurate, specific, and timely risk capture across our Medicare patient population. This is a hands-on, highly visible role for a leader who understands the intersection of clinical documentation, coding operations, technology, and value-based care economics. The ideal candidate brings deep experience with HCC / risk adjustment documentation strategy and thrives on turning complex data and workflows into simple, scalable processes. You’ll partner closely with clinical, technology, and population health leaders to design our risk adjustment playbook, stand up AI-enabled documentation and coding tools, and build a high-performing team that drives both RAF accuracy and great patient care.
Requirements
- 5+ years of experience in value-based care with a focus on HCC/risk adjustment documentation strategies.
- Proven track record of designing documentation strategies and translating them into clear, actionable implementation plans.
- Strong analytical skills with the ability to synthesize data and insights into recommendations, roadmaps, and next steps.
- Demonstrated experience working cross-functionally with clinicians, technology, operations, and revenue cycle teams.
- Exceptional attention to detail and process orientation, with a bias toward building scalable systems over one-off solutions.
- Comfortable operating in ambiguity and high-growth environments; able to work with significant autonomy while keeping stakeholders aligned.
- Experience supervising, mentoring, and providing performance management to direct reports.
- Excellent leadership, collaboration, and communication abilities.
- Mission-driven collaborative mindset and a passion for improving access to high-quality primary care.
Responsibilities
- Partner with the Vice President, Provider Strategy & Population Health to define and own Town Square Health’s risk documentation strategy.
- Leverage prior experience and market research to design a roadmap for “speed to accurate documentation” across all lines of business.
- Identify and prioritize risk documentation workflows that can be automated or augmented with AI-driven tools.
- Collaborate with the Medical Director of Population Health to design provider-friendly documentation workflows that are clinically sound and operationally efficient.
- Serve as project owner for cross-functional risk documentation initiatives, driving clear plans, timelines, and accountabilities.
- Assess buy-vs-build options in partnership with the VP, Provider Strategy & Population Health and Chief Technology Officer.
- Conduct vendor evaluations, including use cases, requirements, ROI, and implementation complexity; synthesize findings and recommendations for leadership.
- Lead operationalization of selected vendors, partnering with Technology and Operations teams on integration, testing, workflow design, and rollout.
- Lead and develop a team of Risk Coders, Revenue Cycle Coders, and RCM Specialists to deliver high-quality documentation and coding.
- Build onboarding, training, and ongoing education programs for coding and documentation teams.
- Serve as a Revenue Cycle subject matter expert to ensure alignment between documentation, coding, and downstream billing/collections processes.
- Monitor performance metrics (e.g., HCC addressable, accuracy of suspects, coder productivity) and implement continuous improvement initiatives.
Benefits
- Competitive compensation and performance-based incentives
- Comprehensive benefits package (medical, dental, vision, 401k)
- Flexible hybrid work model, with preference for candidates who can work in-person 1-2 days a week in our Chicago, IL location.
- Opportunity to make a real impact in transforming how healthcare is delivered to older adults
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What This Job Offers
Job Type
Full-time
Career Level
Director
Education Level
No Education Listed
