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Executive Director, Risk Adjustment Operations

2 months ago

Louisville, Kentucky, United States CenterWell Home Health Full time
About the Role

We are seeking a seasoned executive to lead our Risk Adjustment Operations team as an Executive Director. This is a critical role that will drive strategic initiatives to optimize risk adjustment operations and solutions, delivering quality outcomes and business value.

Key Responsibilities
  • Develop and execute operational strategies to improve risk adjustment operations and solutions.
  • Lead a multi-level team of over 500 associates, with approximately 5 direct reports.
  • Coordinate and oversee multiple vendors, including medical record retrieval and coding vendors, as well as internal operational partners.
  • Oversight and support of all Medicare Market MRA functions.
  • Training and education for all risk adjustment functions.
  • Policies and procedures for all risk adjustment functions.
Requirements
  • 10+ years of leadership experience in the healthcare industry, specifically in risk adjustment operations.
  • Expertise in developing and executing operational strategies.
  • Strong leadership skills, with a proven track record of expanding and elevating the capabilities and performance of a multi-level team and large-scale organization.
  • Bachelor's degree in healthcare administration, business, or a related field. Master's degree is highly desired.
  • Deep knowledge of the health insurance industry, competitive landscape, Medicare operations end-to-end, and a keen respect for compliance and legal guidelines.
  • Proven ability to manage complexity and competing priorities.
  • Excellent oral and written communication skills, including executive presence.
  • Current or recent experience in a large, highly matrixed company (i.e., Fortune 150), with proven ability to influence leaders and key stakeholders.
About Us

CenterWell Home Health is committed to putting health first for our teammates, our customers, and our company. We make it easier for the millions of people we serve to achieve their best health, delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

We are an equal opportunity employer and welcome applications from diverse candidates.