Medicaid Risk Adjustment Market Manager

Job Description

Spearhead Revenue Integrity as the point person across internal market teams. Craft and present executive-level presentations, spotlighting key performance drivers, challenges, and strategic solutions. Investigate operational hurdles affecting market performance, collaborating with partners to implement effective solutions. Track deliverables, pinpoint engagement barriers, and drive resolution implementation. Contribute to the development of educational resources enhancing market intelligence. Engage closely with market clinical, care management, and member services teams, attending relevant market meetings. Utilize project management expertise to orchestrate deliverables, manage timelines, and balance priorities. Collaborate with Informatics to refine requirements, dashboards, and reports. Employ national data tools to unearth opportunities. Present market-specific performance insights at leadership meetings. Oversee risk adjustment strategy and performance, recommending and executing nuanced market tactics to maximize success and referrals. Ensure accuracy and timeliness of risk score performance, collaborating on strategies to boost member engagement. Stay updated on regulatory shifts and risk adjustment practices to enhance team effectiveness. Partner with product, sales, network, and clinical teams to strengthen member and provider engagement, improving outcomes.

Qualifications

1. 5+ years of experience in healthcare operations, risk adjustment, or related areas. 2. 2+ years of experience analyzing performance data and creating executive-ready materials that translate findings into recommendations. 3. 3+ years of experience leading cross-functional projects, managing project plans, and providing status reports. 4. Strong presentation skills to effectively communicate complex information. 5. Proven ability to lead meetings by capturing notes, decisions, and action items. 6. Advanced proficiency in Microsoft PowerPoint for executive-level presentations. 7. Strong working knowledge of Microsoft Excel for data synthesis and communication. 8. Ability to translate data into actionable insights using visuals and storytelling. 9. Rigorous follow-up on takeaways, driving accountability across stakeholders. 10. Knowledge of insurance regulatory and contractual requirements. 11. Self-starter with initiative and a high energy level. 12. Intellectual curiosity and the ability to learn and solve complex problems. 13. Proven ability to manage projects end to end.

Benefits

- Medical, dental, and vision coverage - Paid time off - Retirement savings options - Wellness programs - Other resources, based on eligibility