Risk Adjustment Operations Manager, Remote
Aledade
Operations
Raleigh, NC, USA
Posted on Oct 3, 2024
This job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs, using skills including, but not limited to: capability analysis and definition; operating model definition; incentive model design; governance and decision rights; process engineering, and metrics design. The incumbent works closely with senior/executive leadership, Physicians and technical staff within the Enterprise and within strategic partners, to identify, prioritize, and deliver large and small scale projects that advance business outcomes and achieve strategic objectives relative to new and existing Risk Adjustment Programs. Supports other key objectives designed to build/strengthen patient care delivery and capture of Risk Adjustment documentation/ reporting capabilities, as well as driving continuous improvement efforts. Will be responsible for professional coaching and mentoring of program team members
Primary Duties:
- Lead the day-to-day execution of Strategic Risk Adjustment Program engagements taking ownership of the engagement deliverables, resources, and outcomes. Develop the engagement business case, scope, staffing and incentive model for Risk Adjustment engagement with Providers on internal programs. Lead and manage project team members and/or external consultants by implementing and managing changes and interventions to ensure project goals are achieved.
- Work closely with executive project sponsors and stakeholders to make communication easy and transparent to ensure ongoing alignment with project objectives, activities, and outcomes. Regularly brief the executive leadership of the Enterprise, including CFO, SVP, and Vice President, on project status including program strategy, performance, timelines, risks, and issues.
- Evaluate risks to risk adjustment programs goals and objectives and escalate as appropriate. Conduct periodic market review to understand industry leading practices and drive continuous improvement in department approaches, methods, and tools and organizational awareness of department capabilities.
- Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
- Other duties as assigned or requested.
Minimum Qualifications:
- Bachelor's Degree in Business Administration/Management or Computer and Information Science; Six (6) years relevant and progressive experience in lieu of Bachelor's degree
- 7 - 10 years Project / Program Management: to include 3 - 5 years Leadership; 3 - 5 years Risk Adjustment; 1 - 3 years Strategic Planning
Preferred Qualifications:
- Master's Degree in Business Administration/Management of Healthcare Administration
- 3 - 5 years Healthcare Industry experience
- 1 -3 years Consulting experience
- 1 -3 years Cross-Functional Project Teams experience
- Project Management Professional (PMP)
Who We Are:
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of payers, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives, and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
What Does This Mean for You?
At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents, and domestic partners Robust time off plan 21 days of PTO in your first year 2 Paid Volunteer Days & 11 paid holidays
12 weeks paid Parental Leave for all new parents
6 weeks paid sabbatical after 6 years of service
Educational Assistant Program & Clinical Employee Reimbursement Program
401(K) with up to 4% match
Stock options
And much more!
At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop, and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance, and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
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