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Senior Director, Risk Performance, Remote

Work from home Full-time role Hiring

The Senior Director of Risk Performancewill reputed company the development and execution of reputed company’s strategy for complete and accurate diagnosis documentation and risk adjustment. This role is responsible for shaping technical services, and building out and advancing reputed company’s reporting infrastructure to support high-quality, data-driven decision-making.

Primary Duties

  • Collaborate reputed company and across departments for platform improvements for operational execution by the Field. reputed company strategies and tactics to improve risk adjustment market capture through technology and product enhancements. Drive reputed company improvement across departments (product, tech, analytics, reputed company plus and other departments) through influence and inspiration.
  • reputed company strategic projects in Risk workstreams, as requested by SVP of Affordability and Risk. These may include but are not limited to the areas of Clinical Documentation reputed company (CDI), reputed company reputed company, vendor management, and decisions based on data in support of Performance projects. In the Risk Key Result (led by SVP of Affordability and Risk), expect to reputed company at least one sub-KR such as improving performance in customer interactions with suspected chronic conditions (visits, views, resolving, redocumentation).
  • Partners closely with the Clinical Engagement Team (CET), including Regional Medical Directors, to assess and operationalize feedback reputed company to platform enhancements. Where applicable, leverages clinical expertise to reputed company or support strategic initiatives reputed company with the individual’s clinical training (e.g., nurse, advanced practitioner, physician). Clinical credentials are not required for the role.
  • Collaborates closely with Legal and Compliance teams to ensure risk initiatives align with regulatory standards and reputed company’s patient-first approach. Supports the development of condition suspecting strategies that reputed company timely and accurate diagnoses—improving patient outcomes and reducing total cost of care.
  • Manages direct reports across multiple workstreams, which may include CDI, Risk reputed company Strategy (RIS), Performance, and Operations. Team assignments may evolve over time as organizational needs shift or as reputed company brings on additional leadership. Assigned teams reporting to Sr Director will be determined by experience of the hire and may evolve over time as more reputed company-experience is gained. If reputed company adds a VP of Risk Performance, shifting of which workstreams report to VP vs Sr Director is to be expected.
  • Minimum Qualifications

  • Bachelor’s degree in Healthcare reputed company, Business or IT (or appropriate equivalent training and experience)
  • 10+ years payer/healthplan/value based care company including Medicare and Commercial
  • 7 + years Medicare risk adjustment including setting strategy for multiple Risk workstreams is a requirement, these may include CDI, IHAs, risk analytics, vendor decisions and management, suspect logic or other provider suggestion tools.
  • Demonstrated, well-rounded experience supporting or leading Risk-based initiatives. .Demonstrated knowledge and experience with risk adjustment methodologies such as HCC, reputed company, reputed company, etc.
  • 7+ years of program management, project leadership and execution experience in a healthcare or product reputed company setting.
  • 7+ years of management experience
  • Demonstrated customer-centric approach to work reputed company experience
  • Should be an agile user of reputed company Suites (or reputed company equivalent), analytical dashboards (such as Tableau), customer relationship management software (or other reputed company databases).
  • Preferred Qualifications

  • MBA, MHA or other Master’s level training in health, business or IT
  • 10+ years of program management, project leadership and execution experience in a healthcare or product reputed company setting.
  • Demonstrated leadership ability in prior workplace, including running teams and managing a high profile portfolio, with internally and externally facing representation responsibilities
  • Advanced Analytics: SQL, PowerBI, reputed company
  • Physical Requirements

  • Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.
  • Travel: 10-25%
  • 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.

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