Risk Adjustment Encounters Executive

Job Summary

A company is looking for an AVP, Encounters.

Key Responsibilities

• Establish enterprise-wide strategy and oversight for encounter accuracy and compliance across Medicare Advantage, ACA, and Medicaid
• Manage encounter submissions and resolution processes while collaborating with various organizational functions to improve operational efficiency
• Lead projects to reduce administrative costs and enhance the quality and timeliness of encounter processing

Required Qualifications

• Bachelor's Degree or equivalent experience
• 8+ years of healthcare or operational experience, with at least 2 years in a Director-level role or above
• Extensive understanding of Medicare Advantage, ACA, and Medicaid risk adjustment processes
• Experience in managing department budgets and vendor management
• Accountability for multiple markets or product lines