Employment Type:

　　Full time

　　Shift:

　　Description:

　　*Must live in the South Florida area - this is not a remote position*

　　Roles and Responsibilities

　　Oversee, coordinate, or perform data mining and data-driven analysis to forecast/evaluate the performance of the risk adjustment program and refine annual risk adjustment program strategies to achieve optimal performance. Incorporate data-driven analysis into the risk adjustment processes.

　　Develop and monitor metrics of program success.

　　Oversight of vendor relationships to drive program success (analytics, practice management).

　　Oversight of client contractual requirements and deliverables.

　　Development and monitoring of provider scheduling and prioritization.

　　Identification and development of training opportunities to drive success.

　　Identification and development of process improvement.

　　Measurement and presentation of financial impact to executive leadership.

　　Working across matrixed organization to drive results.

　　Establishes operating policies and procedures for all risk adjustment programs and processes in coordination with internal and external operational units.

　　Represent the organization in dealing with vendors, delegated entities, providers and the Centers for Medicare and Medicaid Services (CMS).

　　Determining resource needs to support incremental functionality required for government products; contributes to budget, and acquires resources accordingly.

　　Develops and maintains relationships with key medical leaders

　　Education & Qualifications

　　South Florida area candidates or candidates willing to relocate

　　Bachelor’s degree from a four-year college required

　　RHIA/RHIT required credentials preferred

　　Specialization in building business units to become more effective and efficient while fostering a team environment

　　7+ years’ experience working in a value-based provider group, health plan, and/or vendor contracting with health plans providing annual wellness/risk adjustment services

　　5+ years’ experience in a leadership role in a capacity developing and implementing risk adjustment, coding, wellness assessment, and analytics programs and processes

　　Expertise in Medicare programs and regulations including fraud and abuse and Medicare Hierarchical Condition Coding Risk Adjustment

　　Excellent analysis and presentation skills

　　Experience working in high-growth environment preferred

　　Valid driver’s license

　　Our Commitment to Diversity and Inclusion

　　Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

　　Our Commitment to Diversity and Inclusion

　　Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

　　Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

　　EOE including disability/veteran