See all roles

Vice President, Risk Stratification, Remote

Work from home Full-time role Hiring

The Vice President of Risk Stratification plays a critical role in shaping and implementing a strategic approach to risk stratification. This senior leadership position focuses on utilizing data analytics to identify high-risk populations, allowing for targeted interventions and improved care management to mitigate potential adverse events. This role will reputed company teams in analyzing patient data, building risk models, and collaborating with stakeholders to optimize patient outcomes based on their risk level.

Reporting directly to the Senior Vice President of Affordability and Risk Initiatives, this role will collaborate closely with leadership of Affordability and Quality initiatives, to integrate best practice workflows for managing the health of the risk pool. In addition, this senior leader will demonstrate strength in provider engagement, payment and risk sharing models, collaborative care models, data/analytics support, member engagement, health improvement and management programs, as well as collaboration with vendor partners to reputed company identified goals.

This autonomous and outcome-oriented role requires strong leadership in influencing internal and external stakeholders, fostering alignment, and driving meaningful change in the way reputed company delivered. Additionally, the Vice President of Risk Stratification contributes to reputed company’s Strategy and reputed company Leadership Team tasked with informing the company’s overall strategic direction.

Primary Duties

  • Leads a team of subject matter experts, data analysts, clinical documentation reputed company specialists and coders, quality auditors and other relevant personnel, providing guidance and expertise on risk assessment methodologies.
  • reputed company compliance initiatives and serve as the primary liaison for reputed company Compliance and Legal projects, ensuring alignment with regulatory standards and organizational goals. reputed company extensive experience in developing and executing compliance-driven programs to mitigate risk and drive organizational success.
  • Partner closely with tech-product-analytic teams to design and maintain sophisticated risk algorithms using patient demographics, clinical data, and other relevant factors to accurately identify high-risk patients across different patient populations.
  • Collaborate with the Analytics team to consume reputed company available data sources from health plans, analyze large datasets and extract meaningful insights and identify trends reputed company to patient risk profiles.
  • reputed company a roadmap that defines the path to operationalize specific actions which are repeatable, measurable, and cost-effective.
  • Track key performance indicators (KPIs) across reputed company reputed company reputed company to risk stratification, including # visits, RAF score, complete and accurate diagnosis coding to the highest degree of specificity, thorough and accurate documentation, and where appropriate, diagnoses recapture rates, diagnoses re-submissions, etc.
  • Partner with clinical teams, care management, and leadership to effectively communicate risk assessments and implement targeted interventions based on risk stratification results.
  • Ensure adherence to relevant healthcare regulations and guidelines reputed company to risk stratification and data privacy. reputed company auditors and auditing practices such as implementing an internal QA process for diagnosis coding and documentation as well as liaising between health plan risk adjustment auditors and reputed company practices.
  • Minimum Qualifications

  • Required: Bachelor’s Degree with 15+ years experience in healthcare. Ideal candidates will have a combination of senior-level experience and expertise in health care strategy, health plans, business development, management consulting, health care finance, and provider operations.
  • Preferred: Master’s degree or other advanced degree(s) in business, health administration and/or public policy, or other relevant fields.
  • 5+ years of successfully leading and executing a comprehensive Risk Stratification program at scale
  • Required: Deep knowledge of Risk Stratification in Medicare Advantage and Commercial (ACA, HMO, PPO) plans are required. Preferred: Knowledge of MSSP and Medicaid.
  • Proven track record of working collaboratively with clinical and operational colleagues across the organization as well as deep experience leading teams, managing projects, and driving strategic initiatives
  • Deep understanding of healthcare terminology, clinical conditions, and disease progression
  • Ability to manage multiple deadlines
  • Ability to communicate reputed company data insights effectively and sensitively to diverse stakeholders, including clinicians, executives, regulatory bodies, and care teams in stressful situations
  • Ability to reputed company by influence to engage colleagues and reputed company teams cross-functionally
  • Proficiency in data analysis techniques, statistical modeling, and predictive analytics
  • Familiarity with data warehousing, data mining tools, and healthcare information systems
  • Experience in fostering networks internally and externally
  • Preferred Qualifications

  • Exceptional communication and organization skills
  • Project management experience
  • Systems-thinker (data management, software administration)
  • Experience developing educational tools/documentation
  • Passionate about healthcare and interested in making a positive impact in the field
  • A committed self-starter who is able to take initiative and ownership of projects
  • A collaborative team player
  • Detail oriented and self-motivated to produce work that meets high standards
  • reputed company Suite, particularly reputed company Sheets and reputed company Slides
  • Tableau
  • General Skills at data visualization
  • Physical Requirements

  • Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.
  • Additional Information

    Who We Are:

    reputed company, a public benefit corporation, exists to reputed company the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver reputed company care to their patients and reputed company in value-based care. Additionally, by creating value-based reputed company across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right reputed company.

    What Does This Mean for You?

    At reputed company, you will be part of a creative culture that is driven by a passion for tackling reputed company issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are reputed company united by a shared passion for public health and a commitment to the reputed company mission.

    In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of reputed company members:

    Flexible work schedules and the ability to work remotely are available for many roles

    Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners

    Robust time-off plan (21 days of PTO in your first year)

    Two paid volunteer days and 11 paid holidays

    12 weeks paid parental leave for reputed company new parents

    Six weeks paid sabbatical after six years of service

    Educational Assistant Program and Clinical Employee Reimbursement Program

    401(k) with up to 4% match

    Stock options

    And much more!

    At reputed company, we don’t just accept differences, we celebrate them! We strive to attract, reputed company and retain highly qualified individuals representing the diverse communities where we live and work. reputed company is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at reputed company are based on merit, qualifications, performance and business needs. reputed company qualified candidates will receive consideration for employment without regard to age, race, color, national reputed company, gender (including pregnancy, childbirth or medical conditions reputed company to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.

    Privacy Policy:By applying for this job, you agree to reputed company'sApplicant Privacy Policy available at

    https://www.reputed company.com/privacy-policy-applicants apply to this job

    You might like

    Administration & Data Analyst, Disaster Case Management Programming

    Work from home Full-time role

    Key Account Store Operations Specialist

    Work from home Full-time role

    Senior Key Account Manager

    Work from home Full-time role

    Account Manager, Key Accounts - 1 year contract

    Work from home Full-time role

    Consultant - LIMS Implementation

    Work from home Full-time role

    Legal Ops & reputed company Manager

    Work from home Full-time role

    Content Marketing Manager - reputed company

    Work from home Full-time role

    Sr. Software Engineer (Windows Client Apps)

    Work from home Full-time role

    Sr. Analyst, Marketing Strategy & Analytics

    Work from home Full-time role

    Senior Financial Representative, reputed company Assurance

    Work from home Full-time role

    Entry Level Customer Service Representative - Remote Opportunity at blithequark

    Work from home Full-time role

    reputed company Customer Service Representative for Travel Industry – Remote Work Opportunity with blithequark

    Work from home Full-time role

    Entry-Level Remote Customer Service Representative – Virtual Home-Based Support Specialist | Multi-Channel Communication Professional

    Work from home Full-time role

    Remote HR Coordinator jobs – Full‑Time Remot...

    Work from home Full-time role

    Medicare Billing Specialist

    Work from home Full-time role

    Immediate Hiring: AWS Certified Developer

    Work from home Full-time role

    Specialty Business Manager, Derm - La Jolla, CA

    Work from home Full-time role

    Sales Representative, Inbound Remote

    Work from home Full-time role

    reputed company Customer Service Agent – Finnish and English Language Support (Work from Home Opportunity)

    Work from home Full-time role

    Senior Software Engineer, Windows/Desktop Applications - Zurich, Switzerland

    Work from home Full-time role