Vice President of Quality and Risk Adjustment

Recruiting Partner: Wynn Gates

Farmington, Utah | Healthcare Services | Fully Remote | $130,000 to $200,000 | Job ID: 139044

Job Summary

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Our client is seeking a Vice President of Quality and Risk Adjustment with a deep understanding of driving value-based healthcare initiatives, improving patient outcomes, and maximizing cost efficiencies using human-centric technology.  

RESPONSIBILITIES

  • Be a pivotal leader in overseeing and enhancing the quality and optimizing risk adjustment within the smart solution products and with our clients and partners.  
  • Lead and develop talent and place the highest priority on being collaborative and fully engaged in the execution and delivery of work. 
  • Monitor Centers for Medicare & Medicaid Services (CMS) regulations related to risk care submissions and reimbursement.
  • Evaluate quality measures using criteria such as: reliability and validity, ease of measurement, field implementation and amenability to quality improvement.
  • Compare the quality of organizations and populations using appropriate statistical tools and methodologies. 
  • Maintain extensive knowledge of the major healthcare quality measure sets including but not limited to Medicare ACO, MIPS, MIPS MVP, CMS Web Interface, HEDIS, CAHPS, AHRQ and Joint Commission.
  • Research the sources of quality data within provider organizations and the issues associated with data capture through electronic medical records (EMRs) or paper charts.
  • Understand the drivers of healthcare quality and accurate documenting and coding in provider organizations, including the roles of people, processes and structure.
  • Be familiar with clinical information system capabilities and limitations (EMRs, patient registries, etc).

QUALIFICATIONS

  • 5-10 years experience working with healthcare quality measure development, research, and/or reporting.
  • Bachelor’s or Master’s degree in Health Information Management or other health- or business-related degree.
  • Deep understanding of driving value-based care initiatives, improving patient outcomes, and maximizing cost efficiencies using human-centric technology.  
  • 3+ Years of progressive career experience in quality and Risk Adjustment.
  • Familiarity with survey research and analysis.
  • Expertise in quality measure construction using claims and clinical datasets.
  • In-depth knowledge of data issues surrounding quality data collection and validation.
  • In-depth knowledge of coding, HCCs, and risk adjustment.
  • Expert level of knowledge of Medicare and risk-based reimbursement methodologies.
  • Knowledge of state and federal regulations with respect to Risk Adjustment and Quality.
  • Ability to interact with physicians and leaders in the business.
  • Licensure or Certification: Certified Professional Coder (CPC) certification or Certified Risk Adjustment Coder (CRC) certification preferred.

BENEFITS

  • $130,000 – $200,000 salary with annual bonuses.
  • Comprehensive health, dental, and vision insurance.
  • Retirement savings plan with company matching.
  • Professional development opportunities and support for certifications.
  • Flexible working hours and remote work options.
  • REMOTE with Quarterly travel to Utah or Arizona.
  • ***MUST BE AUTHORIZED to live and work in the U.S.

At Goodwin Recruiting we are committed to our core values. We take our value, Dedicated to Diversity & Inclusion, very seriously and will never discriminate against a candidate or client based on any protected classes. Our clients seek qualified candidates, and that is what we deliver. A person’s age, gender, race, sexual orientation, gender identity, national origin, veteran or disability status, or arrest or conviction record has no bearing on whether he, she, or they are able to do the job. We evaluate the knowledge, skills, and abilities that meet the requirements of the position and aim to open doors and change lives. We value all people, understanding that uniqueness and diversity foster a stronger team that is innovative and brings varying perspectives to the table. We put our money where our mouth is and are proud of our efforts to identify a broad slate of candidates, with many hiring success stories to share.

 

JOB ID: 139044

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Wynn Gates

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Additional Information

At Goodwin Recruiting we are committed to our core values. We take our value, Dedicated to Diversity, Equity & Inclusion, very seriously and will never discriminate against a candidate or client based on any protected classes. Our clients seek qualified candidates, and that is what we deliver. A person’s age, gender, race, sexual orientation, gender identity, national origin, veteran or disability status, or arrest or conviction record has no bearing on whether he, she, or they are able to do the job. We evaluate the knowledge, skills, and abilities that meet the requirements of the position and aim to open doors and change lives. We value all people, understanding that uniqueness and diversity foster a stronger team that is innovative and brings varying perspectives to the table. We put our money where our mouth is and are proud of our efforts to identify a broad slate of candidates, with many hiring success stories to share.

Wynn Gates

Senior Recruiting Partner

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Additional Information

At Goodwin Recruiting we are committed to our core values. We take our value, Dedicated to Diversity, Equity & Inclusion, very seriously and will never discriminate against a candidate or client based on any protected classes. Our clients seek qualified candidates, and that is what we deliver. A person’s age, gender, race, sexual orientation, gender identity, national origin, veteran or disability status, or arrest or conviction record has no bearing on whether he, she, or they are able to do the job. We evaluate the knowledge, skills, and abilities that meet the requirements of the position and aim to open doors and change lives. We value all people, understanding that uniqueness and diversity foster a stronger team that is innovative and brings varying perspectives to the table. We put our money where our mouth is and are proud of our efforts to identify a broad slate of candidates, with many hiring success stories to share.

Wynn Gates

Senior Recruiting Partner