Navvis (healthcare) · 1 day ago
Director of Risk Adjustment Strategy and Performance
United States
Full-time
Remote
Director/Executive
10+ years expNavvis is a healthcare company seeking a Director of Risk Adjustment Strategy and Performance. This pivotal leadership role is responsible for developing and enhancing risk adjustment programs, leveraging data and technology to improve outcomes and financial performance in the value-based care landscape.
Health CareMedicalmHealth
Responsibilities
Lead the end-to-end design, implementation, and optimization of comprehensive risk adjustment strategies across both health plan and provider partners in partnership with our Physician Executive. Ensure all initiatives are aligned with organizational goals and adhere to all applicable regulatory requirements
Employ advanced data analytics and reporting tools to identify improvement opportunities, continuously monitor program performance, and inform strategic decision-making processes
Develop and implement scalable processes and frameworks that can be efficiently deployed across diverse markets and client segments, supporting sustainable growth and driving operational excellence
Collaborate closely with technology teams to accelerate the adoption of innovative solutions, such as artificial intelligence, automation, and digital platforms. These efforts will enhance data collection, improve coding accuracy, and increase overall program efficiency
Serve as the organization’s subject matter expert on risk adjustment methodologies, regulatory changes, and industry best practices. Provide guidance and educational support to both internal teams and external stakeholders as needed
Build and maintain strong relationships with health plans, provider organizations, and other strategic partners to maximize the impact of risk adjustment initiatives and advance value-based care success
Establish and manage enterprise-level key performance indicators (KPIs), dashboards, and automated reporting systems to monitor RAF/HCC capture, documentation accuracy, provider performance, and financial outcomes
Lead data-driven performance reviews, utilizing actionable insights to reallocate resources toward opportunities that offer the highest value
Measure and improve operational efficiency by evaluating turnaround time, cost per chart, provider burden, and yield per intervention, implementing strategies to enhance these metrics wherever possible
Qualification
Required
Bachelor's degree in healthcare administration, business, or a related field
At least 10 years of experience in risk adjustment, with demonstrated leadership in both health plan and provider settings
Proven expertise in data analytics, program management, and implementing technology-driven solutions within risk adjustment or value-based care environments
Strong knowledge of CMS and commercial risk adjustment regulations, coding standards, and industry trends
Excellent communication skills, with the ability to collaborate and manage stakeholders effectively
Capacity to thrive in a fast-paced, innovative, and mission-driven environment
Preferred
Master's degree
Company
Navvis (healthcare)
Navvis is a leading value-based care enablement company, driving clinical, financial, and operational performance for healthcare organizations.
201-500 employees
H1B Sponsorship
Navvis (healthcare) has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (5)
2024 (6)
2023 (6)
2022 (5)
2021 (2)
Funding
Current Stage
Growth StageTotal Funding
$104.9M2022-10-20Acquired
2021-12-02Series Unknown· $80M
2020-11-18Series Unknown· $10M
Leadership Team
Courtney Fortner
President and CEO
Stuart Baker, MD
Chief Physician Executive, President Emeritus, Co-Founder, Board Director
Recent News
2025-11-29
Company data provided by crunchbase