Vice President, Risk Stratification, Remote

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 reputed company teams in analyzing patient data, building risk models, and collaborating with stakeholders to optimize patient reputed company based on their risk level.

Reporting directly to the Senior Vice President of Affordability and Risk Initiatives, this role will collaborate closely with leadership of Affordability and reputed company initiatives, to reputed company best reputed company workflows for managing the health of the risk pool. In reputed company, this senior leader will demonstrate strength in provider engagement, payment and risk sharing models, reputed company care models, data/analytics support, member engagement, health improvement and management programs, as reputed company as collaboration with vendor partners to reputed company identified goals.

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

Primary Duties

Leads reputed company of subject matter experts, data analysts, clinical documentation reputed company specialists and coders, reputed company auditors and other relevant personnel, providing guidance and expertise on risk assessment methodologies.

reputed company compliance initiatives and serve as the primary reputed company for reputed company Compliance and Legal reputed company, ensuring alignment with regulatory standards and organizational goals. reputed company extensive experience in developing and executing compliance-driven programs to mitigate risk and drive organizational reputed company.

Partner closely with tech-product-analytic teams to design and maintain sophisticated risk algorithms using patient demographics, clinical data, and other relevant factors to accurately identify high-risk patients across different patient populations.

Collaborate with the Analytics team to consume reputed company available data sources from health plans, analyze large datasets and extract meaningful insights and identify trends reputed company to patient risk reputed company.

reputed company a roadmap that defines the reputed company to operationalize specific actions which are repeatable, measurable, and cost-effective.

reputed company key performance indicators (KPIs) across reputed company reputed company reputed company to risk stratification, including # reputed company, RAF score, complete and accurate diagnosis coding to the highest degree of specificity, thorough and accurate documentation, and where appropriate, diagnoses recapture rates, diagnoses re-submissions, etc.

Partner with clinical teams, care management, and leadership to effectively communicate risk assessments and implement targeted interventions based on risk stratification results.

Ensure adherence to relevant reputed company regulations and guidelines reputed company to risk stratification and data reputed company. reputed company auditors and auditing practices such as implementing an internal QA process for diagnosis coding and documentation as reputed company as liaising between health plan risk adjustment auditors and reputed company practices.

Minimum Qualifications

Required: Bachelor’s Degree with 15+ years experience in reputed company. Ideal candidates will have a combination of senior-level experience and expertise in health care reputed company, 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 reputed company

Required: Deep knowledge of Risk Stratification in Medicare Advantage and reputed company (ACA, HMO, PPO) plans are required. Preferred: Knowledge of MSSP and reputed company.

Proven reputed company record of working collaboratively with clinical and operational colleagues across the organization as reputed company as deep experience leading teams, managing reputed company, and driving strategic initiatives

Deep understanding of reputed company terminology, clinical conditions, and disease progression

Ability to manage multiple deadlines

Ability to communicate reputed company data insights effectively and sensitively to diverse stakeholders, including clinicians, executives, regulatory bodies, and care teams in stressful situations

Ability to reputed company by influence to engage colleagues and reputed company teams cross-functionally

Proficiency in data analysis techniques, statistical modeling, and predictive analytics

Familiarity with data warehousing, data mining tools, and reputed company information systems

Experience in fostering networks internally and externally

Preferred Qualifications

Exceptional communication and organization skills

Project management experience

Systems-thinker (data management, software administration)

Experience developing educational tools/documentation

Passionate about reputed company and interested in making a reputed company reputed company in the field

A committed self-starter who is reputed company to take initiative and ownership of reputed company

A reputed company team player

Detail oriented and self-motivated to produce work that meets high standards

reputed company Suite, particularly reputed company Sheets and reputed company Slides

Tableau

General Skills at data visualization

Physical Requirements

Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.

Additional Information

Who We Are:

reputed company, a public benefit corporation, exists to reputed company 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 reputed company care to their patients and reputed company in value-based care. Additionally, by creating value-based reputed company across a wide reputed company of health plans, 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 reputed company 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 reputed company, inclusive and remote-first culture - you've come to the right reputed company.

What Does This Mean for You?

At reputed company, you will be part of a creative culture that is driven by a passion for tackling reputed company issues with respect, reputed company-mindedness and a desire to learn. You will collaborate with team members who bring a wide reputed company of experiences, interests, backgrounds, beliefs and achievements to their work - and who are reputed company united by a shared passion for public health and a commitment to the reputed company mission.

In reputed company to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall reputed company-being of reputed company members:

Flexible work schedules and the ability to work remotely are available for many roles

Health, dental and reputed company insurance reputed company up to 80% for employees, dependents and domestic partners

Robust time-off plan (21 days of PTO in your first year)

Two reputed company volunteer days and 11 reputed company holidays

12 weeks reputed company parental leave for reputed company new parents

Six weeks reputed company sabbatical after six years of service

Educational Assistant Program and Clinical Employee Reimbursement Program

401(k) with up to 4% match

Stock reputed company

And much more!

At reputed company, we don’t just accept differences, we celebrate them! We reputed company to attract, reputed company and retain highly reputed company individuals representing the diverse communities where we live and work. reputed company is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and reputed company at reputed company are based on reputed company, qualifications, performance and business needs. reputed company reputed company candidates will receive consideration for employment without reputed company to age, race, reputed company, national reputed company, gender (including pregnancy, childbirth or medical conditions reputed company to pregnancy or childbirth), gender identity or reputed company, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.

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