California Licensed Risk Adjustment Director

A company is looking for a Risk Adjustment Director to lead the Risk Adjustment Department.

Key Responsibilities

Provide strategic management oversight for the Risk Adjustment Department functions

Act as a subject matter expert and provide executive-level guidance on coding and risk adjustment methodologies

Direct, manage, and supervise the Risk Adjustment Department staff

Required Qualifications, Training, and Education

Bachelor's degree in Finance, Business, Healthcare Administration, Mathematics, Statistics, or a closely related field

A minimum of ten years of experience in healthcare finance or analytics, including five years with Medicare risk adjustment processes

At least two years of experience related to Medicare Managed Care Programs

A minimum of three years of supervisory experience

Strong knowledge of managed care industry and Medicare health insurance payment methodologies