Risk Adjustment Strategic Partner

Intermountain Health • Murray, UT

4d • Hybrid

About The Position

The Risk Adjustment Strategic Partner serves as a liaison between Select Health and provider organizations, clinic leaders, and healthcare providers. The role coordinates workstreams involving risk adjustment, HEDIS and STAR gap closure, and healthcare utilization. It helps providers understand population-health data, use data tools to monitor and analyze trends, identify care gaps, and act on clinic and provider opportunities. The position also develops tailored programs that support value-based healthcare relationships and advises executives on segment-specific strategies, using independent judgment to analyze complex issues and identify solutions.

The role works with provider groups to achieve annual goals, evaluate progress, and conduct outreach and engagement for performance improvement. It monitors program effectiveness, designs reporting for internal and external partners, supports strategic engagements, and collaborates with leadership and internal stakeholders on implementation plans and risk-adjustment initiatives. It also supports provider use of data reports, value-based contracts, quality measures, and risk-adjustment strategies; coordinates interoperability and issue resolution with clinics; manages relevant vendor relationships; and reports monthly KPIs to Select Health leadership.

This is a hybrid position that is mostly remote, with quarterly travel to some local clinics and travel for in-person meetings with provider organizations. The position is based in Murray, Utah, and is scheduled for 40 hours per week. The listed hourly range is $44.99–$69.44, with the actual rate dependent on experience.

Requirements

• Proficiency in risk-adjustment strategy for Medicare and ACA lines of business, including financial impact, RAF score calculations, and return on investment for engagement strategies.
• Demonstrated understanding of HEDIS and STAR measures.
• Knowledge of healthcare regulations and compliance requirements.
• Familiarity with value-based care, provider incentive programs, pay-for-performance (P4P), and quality programs.
• Demonstrated ability to manage projects and teams with a focus on achieving goals and objectives.
• Excellent communication and interpersonal skills, with the ability to build and maintain relationships with internal and external stakeholders.
• Intermediate Excel skills and proficiency with PowerPoint and the Microsoft Suite.
• Ability to present to large groups and internal leadership.
• Strong analytical skills and experience with data analysis and reporting.
• Ability to travel for in-person provider meetings and quarterly visits to some local clinics.

Nice To Haves

• Bachelor’s degree in healthcare administration, business administration, or equivalent work experience.
• Five years of experience in health plan and/or provider administration.

Responsibilities

• Work with provider groups to achieve annual goals, evaluate progress, identify emerging business needs, and conduct provider outreach and engagement for performance improvement.
• Develop strategies to address care gaps and provide actionable solutions for clinics and providers.
• Monitor and analyze program, process, and infrastructure effectiveness, making changes to improve results.
• Design and implement reporting across the risk adjustment organization and with external partners, including the Kidney Team and Group Medicare.
• Support HQRI strategic engagements and represent risk adjustment in new member initiatives and PPO strategies.
• Build and foster relationships with providers and clinical leadership, internally and externally.
• Manage high-priority initiatives proactively and with self-guided leadership.
• Explain and coach provider partners on value-based contracts, quality measures, and risk-adjustment strategies, and help provider groups use data reports effectively.
• Lead operational strategies and collaborate with health-plan partners and Select Health team members to facilitate implementation of services.
• Ensure clinics have appropriate interoperability with Select Health through data transfer and EMR accessibility, and support efficient use of resources.
• Coordinate resolution of issues or concerns between clinic organizations and Select Health.
• Collaborate with internal stakeholders to identify and implement risk-adjustment initiatives aligned with organizational goals and objectives.
• Ensure compliance with regulatory requirements and industry best practices related to population health management.
• Manage vendor relationships that support risk-adjustment activities.
• Report monthly KPIs to Select Health leadership for specific groups, regions, lines of business, and states.
• Advise executives on segment-specific strategies and provide insights on program effectiveness.

Benefits

• A comprehensive benefits package covering programs intended to support health, security, connection, and engagement; specific benefits are not listed.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed