Risk Adjustment Manager

POSITION SUMMARY/RESPONSIBILITIES
Leads the integration of established risk adjustment principles at Community First. Manages system-level data collection, analysis and reporting associated with the integration of quality improvement theory and practice into health plan processes. Direct cross-functional teams through improvement projects and facilitate progress until project goals are met and sustained. Conducts quality improvement services at all levels of the organization, promoting process improvement, the integration of statistical methods, improvement of process outputs and variation reduction. Assists in the development of process metrics, data collection tools/systems and presentation/analysis of resultant data. Delivers system and functional-level reports to the clinical and nonclinical operational and management teams.

EDUCATION/EXPERIENCE
A Bachelor's degree in Nursing, Healthcare Administration, Business or related field is required. Three years of clinical patient care or health care administration experience is required. A Master of Science in Nursing, Healthcare Administration, Business or related field is preferred. Documented work experience in the management of quality data, process improvement and five years experience in the application of quality improvement methodologies with demonstrated proficiency in the application of statistical methods is preferred. The American Society for Quality certification or similar quality certification is preferred.