Assistant Director of Medicare Advantage Risk Adjustment
Job Description
Responsibilities
As member of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director of Risk Adjustment is instrumental in participating in the planning with the director and other functional areas for implementation and execution of strategies, programs, supporting projects, and the monitoring of key performance indicators to enable operational excellence within the risk adjustment department. You will be responsible for coordinating mock RADV audits and compliance audits with the compliance officer and the manager of coding and education. The Assistant Director of Risk Adjustment will oversee the manager of the coding team and our performance improvement specialists. Additional responsibilities will include:
- Collaborate with Senior Data Analyst to identify opportunities for improvement
- Facilitate meetings with other departments as needed to implement and execute on departmental strategy
- Contribute to the development of departmental policies and procedures
- Create reports and presentations to leadership as needed
- Train and develops performance improvement specialist
- Develop policies and procedures with leadership surrounding mock RADV audits
- Assist in developing work flow for risk adjustment activities and programs
- Participate in meetings to create, analyze, apply, interpret and/or communicate policies, procedures and regulations effectively
- Ensure the establishment and compliance of departmental goals and for implementing procedures and performance standards to achieve these goals
- Recommend process improvements based on tracking and trending reports
- Support company activities such as company goals/strategy and management meetings as needed
UCLA Health salary range for this title code is $92,600 – $202,200/annually. Please note that the department’s target pay range is $120,000 – $150,000/annually.
Qualifications
We’re seeking a self-motivated, goal-driven, service-oriented leader with:
- Bachelor’s degree in Healthcare Administration, Public Health, Finance, Business Analytics, or a related field or equivalent experience
- Six or more years of risk adjustment experience
- Eight or more years of progressive responsibility in healthcare
- Experience as a people leader
- Experience in managing projects from end to end
- In-depth knowledge of HCC models V24 and V28
- Familiarity with claims and encounter data processes
- Experience in mock RADV audits
- Strong communication, interpersonal, prioritizing, and organizational skills
- Proven relationship-building with external clients
- Ability to drive process improvement
- Computer proficiency with Microsoft Office, specifically Word and Excel
- Knowledge of Tableau and Microsoft BI
- Ability to effectively articulate strategy to staff and leadership
- Knowledge of STARS and quality measures, preferred
- CPC, CRC, and project management certifications, highly desired
- Health plan and/or consulting background in risk adjustment, highly desired
- Understanding of Six Sigma or LEAN processes a plus
- Ability to work in Pacific Standard Time (PST)
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California. We’re also home to the world-class medical research and clinical education capabilities of the David Geffen School of Medicine. Through the efforts of our outstanding people, we have become Los Angeles’ trusted provider of exceptional, compassionate patient care. If you’re looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.
UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.