Director, Risk Adjustment

PacificSource is looking for a Director of Risk Adjustment to lead enterprise-wide risk adjustment programs across all lines of business, responsible for accurate, complete, and compliant data reporting to CMS. The role involves overseeing analytics and reporting, medical record retrieval, coding operations, and provider engagement, and requires strong leadership and analytical skills.

Requirements

• Establish and maintain the enterprise risk adjustment strategy, governance, and control framework
• Develop and implement scalable prospective programs engagement and education programs
• Support member engagement strategies to strengthen engagement and wrap around services
• Oversee end-to-end Medicare Advantage risk adjustment submissions
• Lead the Risk Adjustment Analytic function
• Ensure audit readiness and response for internal and external audits
• Lead the Risk Adjustment Coding function
• Lead people management activities for all risk adjustment roles
• Direct departmental budgeting and vendor oversight
• Build strong cross department partnerships

Benefits

• Generous Paid Time Off
• 401k Matching
• Retirement Plan
• Tuition Reimbursement