Millennium Physician Group

Compensation

Full Description

Job Description Summary ‎ The Manager of Risk Adjustment Implementation is responsible for coordinating and executing key risk adjustment programs that support accurate HCC capture, documentation quality, and compliance across Medicare Advantage, ACA, and other value-based care models. This role manages day-to-day operational workflows, supports cross-functional implementation efforts, and ensures programs run efficiently and effectively. ‎ How will you make an impact & Requirements ‎ Key Responsibilities Program Implementation & Execution Lead the end-to-end implementation of risk adjustment initiatives, including prospective and retrospective review programs, suspect condition workflows, and clinical documentation improvement efforts. Build and manage implementation roadmaps, timelines, and success metrics for each program. Ensure operational consistency, quality, and compliance across all markets and lines of business. Operational Leadership Oversee day-to-day operations for risk adjustment workflows, ensuring accuracy, productivity, and process adherence. Identify opportunities to streamline or standardize processes to improve efficiency and outcomes. Cross-Functional Collaboration Work closely with Clinical, Coding, Analytics, Operations, and Technology teams to align program requirements and support enterprise-wide initiatives. Collaborate with provider leadership to drive documentation accuracy and adoption of workflow changes. Data-Driven Performance Management Partner with analytics teams to monitor HCC prevalence, RAF impact, coding accuracy, and operational KPIs. Use data insights to identify gaps, recommend improvements, and adjust programs in real time. Provider Engagement & Education Support the development and delivery of provider education on documentation best practices and HCC model requirements. Ensure providers have tools, workflows, and clarity needed to accurately reflect patient complexity. Regulatory & Compliance Oversight Ensure all risk adjustment activities comply with CMS and HHS regulations, coding requirements, and audit standards. Maintain awareness of model changes, policy updates, and documentation guidelines. Beware of fraudulent job postings: While Mosaic Health job advertisements may be found on many sites, our current openings page and its associated Workday account are the only places we accept applications for open roles. If you suspect a job post is fraudulent, please let us know at recruiting@apree.health. Mosaic Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. Learn More about Mosaic Health Learn More about Millennium Physician Group Learn More about CareMore Health Learn More about Castlight Health Learn More about Vera Whole Health