Director, Risk Adjustment

PacificSource is looking for a Director of Risk Adjustment to lead their risk adjustment programs and ensure accurate and compliant data reporting to CMS. The role will oversee a team and collaborate with various departments to drive quality improvement and compliance. The ideal candidate has 5+ years of experience in healthcare, including risk adjustment and team management, with deep knowledge of CMS regulations and provider engagement strategies.

Requirements

• Bachelor's degree in a health-related field, mathematics, or statistics
• Minimum 5 years of experience in a healthcare setting, including at least 3 years directly related to risk adjustment and 3 years of team management experience
• Deep knowledge of risk adjustment strategies, including prospective and retrospective tools, data submission guidelines, and provider engagement approaches
• Experience managing vendor relationships, pricing models, and value-based contracts

Benefits

• Generous Paid Time Off
• 401k Matching
• Health Insurance
• Dental Insurance
• Vision Insurance
• Retirement Plan
• Employee Assistance Program
• Flexible Spending Account