Vice President, Risk Adjustment

Alpine Physician Partners-posted 9 days ago

Full-time • Executive

501-1,000 employees

Resume

Match Score

Upload and Match ResumeTrack Jobs with Teal

The Vice President of Risk Adjustment is the enterprise leader responsible for developing, executing, and continuously improving Alpine’s Medicare Advantage Risk Adjustment strategy and operations across all markets. This role ensures accurate, compliant, and complete capture of patient risk while reducing workflow variation, elevating documentation quality, enabling clinician-friendly processes, that supports Alpine’s mission to deliver transformative senior care. Travel up to 25% is required for this role.

Enterprise Strategy & leadership Develop and execute end-to-end risk adjustment strategy and multiyear roadmap, align coding accuracy, documentation quality, analytics enablement and clinician workflows to drive compliant RAF performance.
Set annual RAF program KPIs with market and clinic level glidepaths to goal; establish management processes for monitoring, reporting and driving corrective actions across markets
Lead enterprise-level governance and serve as Alpine’s subject matter expert on Risk Adjustment, ensuring alignment across Operations, Clinical, Analytics, and Finance.
Program Operations Oversee all prospective, concurrent, and retrospective RAF workflows including robust quality assurance processes to ensure optimized throughput and quality.
Partner with Clinical and Operations leaders to integrate risk adjustment into clinic workflows and processes.
Develop and deliver provider education, coaching, and feedback mechanisms to improve documentation accuracy and reduce burden.
Establish dashboards and KPIs to monitor coding accuracy, completeness, provider engagement, and operational performance
Cross-Functional & External Partnerships Partner with Analytics to leverage opportunity models and predictive insights to guide closed-loop coding and documentation workflows.
Evaluate and optimize technology platforms (e.g., NLP tools, coding engines) to improve accuracy, efficiency, and workflow integration.
Partner with Finance to forecast RAF revenue and evaluate initiative impact.
Collaborate with operations to operationalize RAF workflows, performance expectations, and variation reduction
Regulatory & Compliance Ensure compliance with CMS, HPMS, NCQA, and state regulations.
Lead RADV and other CMS audit activities, ensuring organizational preparedness, submission quality, and corrective action.
Maintain strong internal QA processes to safeguard program integrity and prevent errors.

Bachelor’s degree required; Master’s degree preferred (MPH, MHA, MBA, or related).
Minimum: 10 years of experience in Medicare Advantage Risk Adjustment within a provider organization, health plan, or risk-bearing entity.
Demonstrated success in improving RAF performance and documentation quality at scaled organizations.
Strong leadership experience with ability to influence senior executives, clinicians, operations leaders, and external partners.
Deep understanding of CMS risk adjustment rules, RADV audits, ICD-10 coding standards, V28 transition impacts (if applicable), and documentation requirements.
Experience managing multi-site operations, vendors, budgets, and cross-functional initiatives.
High level of analytical competency with understanding of VBC economics, financial modeling, and operational performance metrics.
Excellent communication, change management, and clinician-engagement skills.

Track Jobs with Teal

Job Search Resources

•

Resume Builder

•

Resume Examples

•

Cover Letter Examples

Vice President, Risk Adjustment

Job Search Resources

Tools

Career Hubs

Guides

Company