What are the responsibilities and job description for the Director of Risk Adjustment position at Village Care?
Join VillageCare in New York City as a Full-Time Director of Risk Adjustment and take your career to the next level while making a meaningful impact in the health care industry. This role offers the flexibility to work from home, allowing you to balance personal and professional commitments seamlessly. You will lead innovative strategies aimed at enhancing patient care while significantly influencing risk management practices. With a competitive salary range of $153,978.55 - $173,225.87, this position not only rewards your expertise but also aligns with your drive for excellence and customer-centricity. Our high-performance culture encourages problem-solving and forward-thinking, ensuring you thrive in a supportive environment.
You will be provided great benefits such as PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b), Life & Disability, Commuter Benefits, Paid Family Leave, and Additional Employee Discounts. If you are ready to contribute to an organization committed to integrity and excellence, apply today and be part of a dynamic team shaping the future of health care.
VillageCare: Our Mission
VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.
Your day as a Director of Risk Adjustment
The Director of Risk Adjustment at VillageCare plays a pivotal role in enhancing the quality of care delivered to our members in New York City. This position focuses on developing and executing a comprehensive annual Risk Adjustment strategy that ensures reimbursements accurately reflect our members' clinical diagnoses. As the leader of the risk adjustment team, you will coordinate internal and external resources to drive initiatives forward while serving as the subject matter expert for business processes and systems. A key responsibility involves creating an annual Provider Risk Adjustment strategy aimed at improving diagnosis coding accuracy through education and engagement with incentive models.
This role also includes assessing strategic performance metrics to support business initiatives and overseeing vendor operations related to risk adjustments. Additionally, you will manage a team of risk adjustment coders, ensuring strict compliance with RADV and other regulatory protocols, ensuring the highest standards of care and accuracy.
What matters most
To excel as the Director of Risk Adjustment at VillageCare, candidates must possess a robust blend of skills and experience. A minimum of 8 years in relevant professional roles is essential, with a strong preference for candidates with Medicare Advantage experience and expertise in risk adjustment specific to these products. Leadership capabilities are critical, including staff and process management experience, to effectively guide the team and drive strategic initiatives.
The ability to multi-task while maintaining a high level of attention to detail is necessary for managing complex projects and meeting regulatory requirements. Strong communication skills-both verbal and written-are vital for effective presentations and interpersonal interactions. Additionally, analytical and logical skills are required for assessing performance metrics and developing actionable strategies.
A Bachelor's degree in Healthcare, Finance, or a related field, or equivalent years of experience, is required to ensure a solid foundation for the responsibilities of this role.
Knowledge and skills required for the position are:
- Experience: Minimum 8 years of relevant professional work experience · Experience in healthcare plan - Medicare Advantage experience preferred · Risk adjustment knowledge and expertise in Medicare Advantage products · Leadership experience including staff and process management experience · Capacity to multi-task at high detail-oriented level · Strong communication skills (verbal, written presentation interpersonal) · Strong analytical and logical skills paired with strong attention to detail Education and certification: · Bachelor's degree in Healthcare, Finance or relevant field or equivalent years of experience required
Are you ready for an exciting opportunity?
If you have these qualities and meet the basic job requirements, we'd love to have you on our team. Apply now using our online application!
Salary : $153,979 - $173,226
