Upvote
Downvote
Director for Quality And Risk Adjustment
Share Job
- Suggest Revision
- The Director for Quality and Risk Adjustment will spearhead the enterprise development of Medicare Star Ratings and Enterprise Risk Adjustment strategies to ensure our risk-adjusted and Star members receive optimal clinical and pharmacy care at the right time.
- Lead enterprise efforts to maximize the Medicare CMS Star Rating and other quality programs supporting commercial, ACA, and Medicaid lines of business.
- Develop a multi-year strategy in collaboration with organizational stakeholders, including Health Care Management, Client Services, Network Operations, and other business units, to drive process changes across the organization to improve performance.
- Lead the strategic direction of quality assurance, coding, submissions, and audit services for risk adjustment revenue optimization.
- Coordinate with existing vendors, and/or identify and implement new vendors, to drive desired outcomes in risk-adjustment activities.
Active Job
Updated 21 days agoSimilar Job
Relevance
Active