Alpine Physician Partners · 3 hours ago
Vice President, Risk Adjustment
California, United States
Full-time
Hybrid
Director/Executive
10+ years expAlpine Physician Partners is committed to delivering transformative senior care, and they are seeking a Vice President of Risk Adjustment to lead their Medicare Advantage Risk Adjustment strategy and operations. This role involves developing strategies, overseeing quality assurance processes, and ensuring compliance with regulations while collaborating across various departments to optimize operations.
Health CareMedicalNursing and Residential CarePrimary and Urgent Care
Responsibilities
Develop and execute end-to-end risk adjustment strategy and multiyear roadmap, align coding accuracy, documentation quality, analytics enablement and clinician workflows to drive compliant RAF performance
Set annual RAF program KPIs with market and clinic level glidepaths to goal; establish management processes for monitoring, reporting and driving corrective actions across markets
Lead enterprise-level governance and serve as Alpine’s subject matter expert on Risk Adjustment, ensuring alignment across Operations, Clinical, Analytics, and Finance
Oversee all prospective, concurrent, and retrospective RAF workflows including robust quality assurance processes to ensure optimized throughput and quality
Partner with Clinical and Operations leaders to integrate risk adjustment into clinic workflows and processes
Develop and deliver provider education, coaching, and feedback mechanisms to improve documentation accuracy and reduce burden
Establish dashboards and KPIs to monitor coding accuracy, completeness, provider engagement, and operational performance
Partner with Analytics to leverage opportunity models and predictive insights to guide closed-loop coding and documentation workflows
Evaluate and optimize technology platforms (e.g., NLP tools, coding engines) to improve accuracy, efficiency, and workflow integration
Partner with Finance to forecast RAF revenue and evaluate initiative impact
Collaborate with operations to operationalize RAF workflows, performance expectations, and variation reduction
Ensure compliance with CMS, HPMS, NCQA, and state regulations
Lead RADV and other CMS audit activities, ensuring organizational preparedness, submission quality, and corrective action
Maintain strong internal QA processes to safeguard program integrity and prevent errors
Qualification
Required
Bachelor's degree required
10 years of experience in Medicare Advantage Risk Adjustment within a provider organization, health plan, or risk-bearing entity
Demonstrated success in improving RAF performance and documentation quality at scaled organizations
Strong leadership experience with ability to influence senior executives, clinicians, operations leaders, and external partners
Deep understanding of CMS risk adjustment rules, RADV audits, ICD-10 coding standards, V28 transition impacts (if applicable), and documentation requirements
Experience managing multi-site operations, vendors, budgets, and cross-functional initiatives
High level of analytical competency with understanding of VBC economics, financial modeling, and operational performance metrics
Excellent communication, change management, and clinician-engagement skills
Structured & Systems Thinking: Connects coding, clinical practice, analytics, and financial outcomes into a unified enterprise strategy
Cross-Functional Influence: Builds alignment across diverse stakeholder groups
Operational Excellence: Drives measurable improvements through disciplined processes and accountability
Change Management Leadership: Leads providers and teams through behavior change with clarity and empathy
Technical Fluency: Understands risk coding platforms, data systems, analytics tools, and EMRs
Regulatory Rigor: Maintains a high-integrity, compliant, audit-ready program at all times
Preferred
Master's degree preferred (MPH, MHA, MBA, or related)
Company
Alpine Physician Partners
Alpine Physician Partners is a medical care center that offers machine learning, house calls, and urgent care at-home programs.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Catherine Crow
Chief People Officer
Karen Xie
Chief Digital Officer
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