Risk Adjustment Program Manager
22 hours ago
Hybrid Work Environment - Must reside in Hawaii
The Risk Adjustment Program Manager has organization-level responsibilities for the administration of all provisions/requirements of HMSA's Medicare Risk Adjustment program. They are responsible for managing the development and implementation of successful activities that improve the accuracy of the CMS risk adjustment scores of the Medicare Advantage membership.
Key Responsibilities- Develop and implement strategies to meet risk adjustment accuracy goals and requirements.
- Manage the production of performance dashboards to monitor and report ongoing performance against targets.
- Ensure processes and documentation support risk adjustment program requirements.
- Support internal and external teams as a subject matter expert of Medicare Advantage Risk Adjustment.
- Manage necessary changes to existing systems, operations, or workflows to address new/revised requirements of CMS/DHS/MQD.
- Direct regular organization-wide training to develop staff in other key departments as risk adjustment subject matter experts.
- Meet with senior leadership to review progress, report key results, and program performance measures.
- Bachelor's degree and five years of related work experience, or an equivalent combination of education and experience.
- Two years of leadership or management/supervisory experience.
- Effective verbal and written communication skills.
- Basic knowledge of Microsoft Office applications.
HMSA is a leading healthcare organization in Hawaii, dedicated to providing high-quality healthcare services to its members.
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