Vice President, Risk Adjustment

Role Overview

The Vice President of Risk Stratification plays a critical role in shaping and implementing a strategic approach to risk stratification. This senior leadership position focuses on utilizing data analytics to identify high-risk populations, allowing for targeted interventions and improved care management to mitigate potential adverse events. This role will lead teams in analyzing patient data, building risk models, and collaborating with stakeholders to optimize patient outcomes based on their risk level.

This role will collaborate closely with leadership of Affordability and Quality initiatives, to integrate best practice workflows for managing the health of the risk pool. In addition, this senior leader will demonstrate strength in provider engagement, payment and risk sharing models, collaborative care models, data/analytics support, member engagement, health improvement and management programs, as well as collaboration with vendor partners to achieve identified goals.  

This autonomous and outcome-oriented role requires strong leadership in influencing  internal and external stakeholders, fostering alignment, and driving meaningful change in the way healthcare is delivered. Additionally, the Vice President of Risk Stratification contributes to Aledade’s Strategy and Priority Leadership Team tasked with informing the company’s overall strategic direction.

Requirements

• Required: Bachelor’s Degree with 15+ years experience in healthcare. Ideal candidates will have a combination of senior-level experience and expertise in health care strategy, health plans, business development, management consulting, health care finance, and provider operations.
• Preferred: Master’s degree or other advanced degree(s) in business, health administration and/or public policy, or other relevant fields.
• 5+ years of successfully leading and executing a comprehensive Risk Stratification program at scale
• Required: Deep knowledge of Risk Stratification in Medicare Advantage and Commercial (ACA, HMO, PPO) plans are required. Preferred: Knowledge of MSSP and Medicaid.
• Proven track record of working collaboratively with clinical and operational colleagues across the organization as well as deep experience leading teams, managing projects, and driving strategic initiatives
• Deep understanding of healthcare terminology, clinical conditions, and disease progression
• Ability to manage multiple deadlines
• Ability to communicate complex data insights effectively and sensitively to diverse stakeholders, including clinicians, executives, regulatory bodies, and care teams in stressful situations
• Ability to lead by influence to engage colleagues and lead teams cross-functionally
• Proficiency in data analysis techniques, statistical modeling, and predictive analytics
• Familiarity with data warehousing, data mining tools, and healthcare information systems
• Experience in fostering networks internally and externally

Benefits

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) Two paid volunteer days and 11 paid holidays 12 weeks paid parental leave for all new parents Six weeks paid sabbatical after six years of service Educational Assistant Program and Clinical Employee Reimbursement Program 401(k) with up to 4% match Stock options And much more!