Senior Vice President, National Risk Adjustment Strategy
4 days ago
The Senior Vice President, National Risk Adjustment Strategy will be responsible for developing and executing a comprehensive risk adjustment strategy to ensure the accuracy and completeness of clinical data submitted to regulators and customers. This role will require a deep understanding of the regulatory environment, clinical data integrity, and risk stratification.
Key Responsibilities:
- Strategy and Vision: Develop and implement a risk adjustment strategy that aligns with Kaiser Permanente's quality and financial goals.
- Clinical Data Integrity and Accuracy: Ensure the accuracy and completeness of clinical data submitted to regulators and customers.
- Risk Stratification and Prospective Algorithms: Evaluate and implement analytical and predictive tools to identify care gaps and promote comprehensive care.
- Clinical Program Development and Quality Strategy: Leverage risk adjustment data to inform clinical programs and quality strategies.
- Data Submission and Reconciliation: Ensure the accuracy, completeness, and timeliness of data submissions to regulators and customers.
- Performance Management, Reporting, and Benchmarking: Develop a comprehensive data analytics strategy and performance management reporting suite.
- Risk Adjustment Factor Forecasting: Support the accurate development of risk adjustment forecasting for financial and clinical modeling.
- Product Development and Growth Strategy: Partner with actuarial and product teams to leverage condition prevalence data and forecasts to improve product offerings.
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Oakland, California, United States Kaiser Permanente Full timeJob Summary:The Senior Vice President, National Risk Adjustment Strategy will be responsible for developing and executing a comprehensive risk adjustment strategy for Kaiser Permanente's National Health Plan. This role will require a deep understanding of the regulatory environment, risk adjustment models, and data analytics. The successful candidate will...
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Vice President and Chief Risk Officer
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Oakland, California, United States Altais Full timeJob Title: Senior Coding Analyst, Risk AdjustmentAbout the Role:We are seeking a highly skilled Senior Coding Analyst, Risk Adjustment to join our team at Altais. As a key member of our Clinical Performance team, you will play a critical role in ensuring the accuracy and compliance of our risk adjustment coding efforts.Key Responsibilities:Review and audit...
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