Vice President of Risk Adjustment

Vice President of Risk Adjustment

Executive Gilbert, Arizona Minimum Experience Mid-level Job Description :

The Vice President of Risk Adjustment is responsible for the oversight of Clinical Risk Adjustment activities including staff performance, reporting, and documentation management.

The duties include but are not limited to recruitment, retention, supervision, and mentoring. The VP provides leadership and fosters cooperation, collaboration, and collegiality among their team members and our provider colleagues.

The incumbent is personally responsible for promoting and maintaining excellence and integrity in risk adjustment initiatives, and in enhancing the quality of risk adjustment training.

Specifically, the VP of Risk Adjustment is responsible for the orientation, education, and training of all network providers in clinical documentation quality and subsequently in population health management of assigned patients to achieve the quadruple aim.

The VP of Risk Adjustment maintains the integrity of the department by proper utilization of fiscal resources, and personnel matters.

The VP attends / leads clinic / regional / national level meetings to present material and learning opportunities for improving patient outcomes and program management (such as Quality, STARs, Clinical Documentation, comprehensive care, and care coordination, among others).

The Company :

This role is with US Health Systems, an Arkos Health Company. Arkos serves health plans and provider organizations an integrated system-of-care comprised of clinical and social services backed by a robust technology platform.

By engaging individuals with virtual, in-home, in-clinic and in-facility care options, Arkos Health delivers advanced community-based health services that allow our clients to live healthier, more independent lives.

All Employee MUST be fully COVID-19 Vaccinated.

Essential Duties and Responsibilities :

• Oversees the Provider Education department including direct oversight of Associate Medical Directors.
• In collaboration with the VP of Quality & Performance, oversees strategy / risk adjustment training / performance for Provider Relations department to achieve provider engagement, risk adjustment and quality goals.
• In collaboration with the VP of Clinical Services, oversees risk adjustment training / performance for the Home Wellness team / providers.
• Reviews charts regularly to aid in the education process and discover opportunities for continuous improvement of patient outcomes.

Meets expected productivity in chart review to inform programming needs.

• Develop ongoing chart review processes to ensure continued high standards in clinical judgment, and completeness, as well as aid in developing and monitoring inter-reviewer reliability testing.
• Assist with the evaluation of new technologies / vendors related to Risk Adjustment and Quality.
• Provide mentoring to providers on managed care and professional development issues to support improved provider engagement and retention.
• Coach providers and deliver feedback in a constructive manner that leads to improved provider engagement and enhanced clinical behavior.
• Analyze data, prepare, and implement action plans to help improve provider and clinical performance / outcomes.
• Analyze practice data / documentation patterns, strategize, and coordinate with Associate Medical Directors / Provider Relations Director to implement effective changes for improved performance.

Qualifications / Skills :

• Experience in and knowledge of CPT, ICD, HCPCS, HCC coding , and Risk Adjustment
• Medical degree
• Current, active license to practice medicine in the state of Arizona preferred. (Multi-state cross-licensure may be required)
• Minimum of 5 years' work experience related to clinical documentation, clinical risk adjustment, and patient population health management
• Strong communication and interpersonal skills

Benefits :

• Fully paid employee medical / dental / vision / life / short term disability
• Employer matching 401(k)
• Annual sick / PTO with 9 paid holidays

Must complete our Culture Index Survey. Take the assessment at . This is not a pass / fail test and does not measure intelligence.

Arkos Health EEO Statement

All Arkos Health divisions are Equal Opportunity Employers. We do not discriminate on the basis of race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status or any other status protected under federal, state or local laws.

Arkos Health is a drug free workplace. All job applicants selected for employment are required to submit to a pre-employment drug test and background check.

Location Gilbert, Arizona Minimum Experience Mid-level