Vice President of Quality & Risk Adjustment

About the Company

Well-established healthcare services company

Industry
Hospital & Health Care

Type
Privately Held

About the Role

The Company is in search of a Vice President of Quality and Risk Adjustment with a strong background in driving value-based healthcare initiatives, enhancing patient outcomes, and maximizing cost efficiencies through the use of technology. The successful candidate will be a key leader in the optimization of quality and risk adjustment, both internally and in collaboration with clients and partners. Responsibilities include overseeing and enhancing quality, monitoring regulatory compliance, evaluating quality measures, and maintaining a deep understanding of major healthcare quality measure sets. The role also involves research on quality data sources, understanding healthcare quality drivers, and being familiar with clinical information system capabilities.Applicants for the Vice President position should have 5-10 years of experience in healthcare quality measure development, research, or reporting, and hold a Bachelor’s or Master’s degree in a relevant field. A deep understanding of value-based care, patient outcome improvement, and cost efficiency is essential, as is a progressive career in quality and risk adjustment. The role requires expertise in quality measure construction, data issues in quality data collection, and validation, as well as in coding, HCCs, and risk adjustment. An expert level of knowledge of Medicare and risk-based reimbursement methodologies, along with the ability to interact effectively with physicians and business leaders, is also necessary. Professional coding or risk adjustment certification is preferred.

Travel Percent
Less than 10%

Functions

• Operations
• Medical Care/Hospital Administration