Manager, Value-Based Care, Risk Adjustment & Quality

Hartford HealthCare Corp.•Hartford, CT

11d•Onsite

About The Position

Hartford HealthCare is seeking an Advanced Practice Provider to join its Clinical Integration team. The Manager provides clinical, operational, and strategic leadership to advance value-based care performance, risk adjustment accuracy, quality improvement, and documentation integrity across the Clinically Integrated Network (CIN). In partnership with the Medical Director for Risk Adjustment, the Manager oversees the Risk Adjustment Coding and Education team, drives provider engagement, ensures regulatory compliance, and promotes best practices in clinical documentation, coding accuracy, and quality measure performance. In partnership with the Medical Director of Value Based Care, the Manager collaborates with clinical, operational, and administrative leaders to improve population health outcomes, optimize financial performance under value-based contracts, and strengthen quality and risk-adjusted performance metrics. Through education, incentive plans, analytics, and provider partnership, this role advances organizational strategic goals by engaging providers in the Integrated Care Program (ICP) and fostering accountability, continuous improvement, and high-quality, patient-centered care.

Requirements

Licensed or eligible to be licensed in the State of Connecticut.
Advanced Practitioner Registered Nurse (APRN) or Physician Assistant (PA).
Minimum of five years of progressive clinical experience.

Responsibilities

Oversee the Risk Adjustment Coding and Education team.
Lead documentation integrity initiatives and improve coding accuracy and risk capture.
Support quality measure documentation and collaborate with CDI, coding, and operational leaders.
Develop and execute Clinically Integrated Network value-based care strategies.
Align risk, quality, and financial performance goals.
Design and oversee provider incentive programs.
Advance population health and contract performance initiatives in partnership with Medical Directors and operational leadership.
Educate and coach providers; develop physician and APP champions.
Create departmental and specialty-specific engagement strategies.
Conduct performance reviews using scorecards and dashboards.
Lead change management and adoption of value-based care initiatives.
Communicate quality, risk, and incentive opportunities.
Monitor and report quality and risk-adjustment KPIs.
Conduct gap analysis, benchmarking, and trend analysis; develop performance improvement plans.
Use data-driven interventions to improve quality outcomes and financial performance.
Oversee compliance with CMS, MSSP, Medicare Advantage, and payer requirements.
Prepare for and monitor audits, provide regulatory education, mitigate risk, and oversee documentation and coding compliance.