Director Risk Adjustment

Description

Calling All Esteemed Leaders! Are you a visionary with a strategic mindset, passionate about revolutionizing healthcare delivery? Do you excel at navigating complex challenges and driving innovation in the healthcare sector? If so, we have an exciting opportunity for you! We are seeking individuals to work mostly remotely in the states of WA, OR and CA.

The Role:

As the Director of Risk Adjustment and Strategic Accounts at Providence Health Plan, you will be the cornerstone of our strategic vision. You will oversee risk adjustment programs, spearhead provider education, and enhance engagement to support value-based contracting performance. Your leadership will be vital in executing business objectives, developing and implementing strategies for risk adjustment and strategic accounts, and advocating for our organization to governmental agencies.

What You'll Do:

• Strategic Oversight: Direct the development and execution of risk adjustment strategies, ensuring alignment with business objectives.
• Compliance Leadership: Manage all compliance activities and programs, serving as the voice of advocacy to government entities.
• Cross-Functional Collaboration: Work closely with various departments to enhance relationships and performance, driving efficiency and innovation.
• Operational Excellence: Ensure the efficient operation of the Risk Adjustment Department, overseeing budgets and solving complex problems.
• Education & Outreach: Develop strategies for provider education and outreach, enhancing coding compliance standards.
• Regulatory Management: Supervise all changes related to industry coding standards and oversee regulatory audits.
• Vendor Solutions & Reporting: Implement, manage, and present solutions and reports to senior leaders, supporting strategic decisions.

What You'll Bring:

• Educational Background: Bachelor's Degree in Business Administration, Economics, Healthcare Administration, or equivalent education/experience. A Master's degree in a related field is preferred.
• Experience: At least 7 years of experience with Medicare, Medicaid, and Commercial risk adjustment processes, plus 5 years of progressive management experience.
• Certification: Certified Risk Adjustment Coder (CRC) is preferred.
• Skills & Expertise: Strong strategic acumen, problem-solving skills, and the ability to foster healthy, productive relationships.

Why Join Us?

• Transform Healthcare: Play a pivotal role in transforming healthcare delivery, impacting countless lives.
• Innovative Environment: Embrace the opportunity to unleash your potential in a dynamic, fast-paced industry.
• Collaborative Culture: Work with passionate, dedicated professionals committed to excellence.
• Professional Growth: Enjoy autonomy and support to bring your innovative ideas to life.
• Advocacy & Impact: Represent Providence Health Plan in advocacy, shaping the future of healthcare delivery.

Ready to Shape the Future of Healthcare?

If you're a strategic leader with a passion for healthcare innovation, we encourage you to apply and join our mission to create a healthier future for all.

About Providence

At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."

About the Team

Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 387015

Company: Providence Jobs

Job Category: Risk

Job Function: Legal/Compliance/Risk

Job Schedule: Full time

Job Shift: Day

Career Track: Leadership

Department: 5018 STRATEGIC PLANNING

Address: OR Portland 4400 NE Halsey St

Work Location: Providence Office Park Portland Bldg 1-Portland

Workplace Type: Remote

Pay Range: $71.15 - $112.34

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.