Manager, Risk Adjustment - Health Plan

Job description

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: Day (United States of America) Scheduled Weekly Hours: 40 Union Position: No Department Details: Summary: The Manager, Risk Adjustment is responsible for managing and overseeing the end-to-end execution of the Risk Adjustment Program, including strategy and operations for all health plan government programs (ACA and Medicare Advantage). Job Description: The Manager of Risk Adjustment will have oversight of end-to-end risk adjustment operations, programs, strategy, and data integrity; risk adjustment vendor selection, implementation, and quality oversight; retrospective and prospective program design, implementation, and oversight; design and oversight of Hierarchical Condition Category (HCC)/clinical documentation operations, quality oversight, education, and analytics. The Manager will work across multiple operation teams to develop or improve systems, processes and...