AVP, Medicare Risk Adjustment Performance
Core
Executive leadership for enterprise Medicare Risk Adjustment performance strategy, operations, and financial outcomes.
Role type
Senior IC strategy & operations leader (Medicare Risk Adjustment)
Builds
Enterprise Risk Adjustment strategies, provider engagement programs, coding operations, and analytics capabilities
Domain
Healthcare / Medicare Risk Adjustment / Revenue Integrity
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure
Required skills
Strategic planning, financial forecasting, vendor management, provider relationship management, operational performance monitoring, regulatory compliance, team leadership, business case development, data strategy
Preferred skills
Experience with CMS risk adjustment models, knowledge of RADV readiness, expertise in workflow modernization and automation
Technologies
Enterprise analytics platforms, reporting tools, workflow automation systems
Responsibilities
Lead annual operating plans for Medicare risk adjustment, oversee prospective/concurrent/retrospective execution strategies, manage vendor partnerships and contracts, drive provider performance improvement initiatives, partner with finance and actuarial teams on revenue forecasting, develop multi-year performance strategies, mentor high-performing teams
Seniority
Senior, hands-on IC with strategic oversight