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CINQCARE · 2 months ago

Risk Adjustment and Quality Reporting Manager

United States

Full-time

Onsite

Mid, Senior Level

$110K/yr - $120K/yr

5+ years exp

CINQCARE is a provider-led, community-based health and care partner focused on improving health outcomes for high-needs communities. The Risk Adjustment & Quality Reporting Manager will lead the implementation of risk adjustment strategies, monitor their effectiveness, and collaborate with clinical teams to enhance quality performance and ensure accurate documentation of high-risk patients.

CommunitiesHealth CareHome Health CareMedical

Responsibilities

Lead the implementation and ongoing management of risk adjustment strategies to ensure accurate risk scores and optimal reimbursement

Monitor and analyze the effectiveness of risk adjustment initiatives and adjust strategies to improve performance

Collaborate with clinical teams to identify high-risk patients and ensure that all relevant diagnoses are appropriately captured and documented

Analyze data to identify trends, gaps, and opportunities in risk adjustment and quality performance

Prepare and present regular reports to senior leadership, detailing performance on risk adjustment, quality reporting, and regulatory compliance

Use data to inform decision-making and drive initiatives for improvement in risk adjustment and quality outcomes

Qualification

Risk adjustment strategiesQuality reportingData analysisHealthcare industry experienceMicrosoft Office proficiencyRelationship managementJudgmentEthicsCommunication skillsTeam player

Required

Bachelor's degree or equivalent degree with a record of strong academic achievement

At least 5 years of quality & risk experience. Ideal candidates will have 5+ years of relevant quality & risk experience in the healthcare industry

Excellent verbal, written communication and presentation skills; ability to clearly articulate and present concepts and models in an accessible manner to CINQ's team, investors, partners and other stakeholders

Proficiency in all Microsoft Office applications

Ability to build and effectively manage relationships with business leaders and external constituents

Good judgement, impeccable ethics, and a strong team player; desire to succeed and grow in a fast-paced, demanding and entrepreneurial Company