Risk Adjustment Senior Manager

Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services—creating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 750,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world’s leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. We are uniquely able to deliver tangible outcomes because of our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song. These capabilities, together with our culture of shared success and commitment to creating 360° value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360° value we create for our clients, each other, our shareholders, partners and communities. Visit us at www.accenture.com .

Strategy & Consulting : We work with C-suite executives, leaders and boards of the world’s leading organizations, helping them reinvent every part of their enterprise to drive greater growth, enhance competitiveness, implement operational improvements, reduce cost, deliver sustainable 360° stakeholder value, and set a new performance frontier for themselves and the industry in which they operate. Our deep industry and functional expertise is supported by proprietary assets and solutions that help organizations transform faster and become more resilient. Underpinned by technology, data, analytics, AI, change management, talent and sustainability capabilities, our Strategy & Consulting services help architect and accelerate all aspects of an organization’s total enterprise reinvention.

As a Risk Adjustment Operations Leader, your primary responsibilities may include :

Product Roadmap Development and Maintenance

Lead the development and continuous refinement of the firm’s r isk a djustment product roadmap.

Ensure the product offering leverages cutting‑edge technology, including AI‑driven chart reviews and advanced analytics.

Performance Management

Establish and oversee performance management processes, ensuring operational excellence and superior client outcomes.

Develop and maintain reporting frameworks to monitor performance metrics, identifying areas for improvement.

Client Management

Serve as the subject matter advisor and primary point of contact for health clients for risk adjustment services .

Proactively identify and communicate risks, issues, and improvement opportunities to clients.

Set and manage client expectations, ensuring satisfaction and alignment with service objectives .

Regulatory Compliance

Monitor regulatory changes, including CMS and HHS guidelines, and ensure risk adjustment services remain compliant.

Oversee enhancements to processes and tools in response to evolving regulatory requirements.

Operational Excellence

Oversee the performance of automated processes, including AI‑based chart reviews and risk adjustment analytics.

Identify opportunities to improve speed, breadth, and accuracy of risk adjustment operations.

Business Development

Support sales initiatives, contributing to proposals and presentations to secure new clients.

Leverage industry insights to identify growth opportunities and expand the firm’s risk adjustment client base.

Team Leadership

Build, mentor, and provide strategic direction to a team of junior resources.

Foster a culture of continuous improvement, ensuring the team delivers high‑quality, efficient services.

Travel

As needed, up to 80%

Why should I join the Accenture Health team?

Innovate every day. Be at the forefront of designing and delivering health technology solutions that push boundaries and create new opportunities for our clients.

Lead with the industry’s best . Join an industry‑recognized healthcare leader with more than 20,000 global healthcare professionals collaborating to drive enterprise‑wide transformational projects on a global scale. Accenture has worked with more than 200 clients to deliver healthcare transformation to meet the diverse needs of patients and members.

Learn and grow continuously. Harness unmatched training and professional development to help you build and advance your health, consultative and delivery skills. With learning resources, interactive classroom courses, real‑life client simulations and ongoing mentoring available when you need it, you’ll expand your thinking beyond the core Workday implementation.

Here’s what you need :

Bachelor’s degree in Business Administration , Health Administration, Information Technology, or related field preferred.

A minimum of 5 years of experience in healthcare consulting, or risk management operations with a health plan or risk adjustment service provider.

A minimum of 5 years of experience planning, securing funding for, and executing a roadmap for continual improvement of risk adjustment capabilities .

Bonus points if you have :

Master’s degree preferred.

Experience working with or leading global teams.

Thrive in a diverse, fast paced environment.

Exceptional problem‑solving and analytical skills.

Excellent communication and presentation abilities.

Leadership experience, including team management and project oversight.

Experience leveraging automation for medical chart capture and AI for supporting medical chart reviews.

Experience presenting operational and financial impacts of risk adjustment services to health plan leadership.

Participated in CMS compliance audits.

Certified medical coder.

Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired as set forth below.We accept applications on an on-going basis and there is no fixed deadline to apply.

Information on benefits is here. (https : / / www.accenture.com / us-en / careers / local / total-rewards)

Role Location Annual Salary Range

California $132,500 to $302,400

Cleveland $122,700 to $241,900

Colorado $132,500 to $261,300

District of Columbia $141,100 to $278,200

Illinois $122,700 to $261,300

Maryland $132,500 to $261,300

Massachusetts $132,500 to $278,200

Minnesota $132,500 to $261,300

New York / New Jersey $122,700 to $302,400

Washington $141,100 to $278,200

Requesting an Accommodation

Accenture is committed to providing equal employment opportunities for persons with disabilities or religious observances, including reasonable accommodation when needed. If you are hired by Accenture and require accommodation to perform the essential functions of your role, you will be asked to participate in our reasonable accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodations once hired.

If you would like to be considered for employment opportunities with Accenture and have accommodation needs such as for a disability or religious observance, please call us toll free at 1 (877) 889-9009 or send us an email or speak with your recruiter.

Equal Employment Opportunity Statement

We believe that no one should be discriminated against because of their differences. All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law. Our rich diversity makes us more innovative, more competitive, and more creative, which helps us better serve our clients and our communities.

For details, view a copy of the Accenture Equal Opportunity Statement (https : / / www.accenture.com / content / dam / accenture / final / accenture-com / document-3 / Accenture-Equal-Employment-Opportunity-Statement.pdf#zoom=50)

Accenture is an EEO and Affluent Action Employer of Veterans / Individuals with Disabilities.

Accenture is committed to providing veteran employment opportunities to our service men and women.

Other Employment Statements

Applicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States.

Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration.

Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process. Further, at Accenture a criminal conviction history is not an absolute bar to employment.

The Company will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Additionally, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.

California requires additional notifications for applicants and employees. If you are a California resident, live in or plan to work from Los Angeles County upon being hired for this position, please click here for additional important information. Please read Accenture’s Recruiting and Hiring Statement for more information on how we process your data during the Recruiting and Hiring process.

#J-18808-Ljbffr