Description
The Risk Adjustment Strategic Partner works as a liaison between the provider community and SelectHealth, focusing on risk adjustment, HEDIS and STAR gap closure, and healthcare utilisation. This role requires specialised skills to build relationships with provider organisations, clinic leaders, and healthcare providers. The successful candidate will ensure providers understand multiple data points relevant to population health, navigate data tools, and develop strategies to address gaps in care.
Key Responsibilities:
- Coordinate workstreams, including risk adjustment, HEDIS and STAR gap closure, and healthcare utilisation
- Develop strategies to address gaps in care and provide solutions for actionable clinic and provider opportunities
- Foster relationships with providers and clinical leadership, internally and externally
- Manage high-priority initiatives effectively, demonstrating proactive approach and self-guided leadership
- Collaborate with internal stakeholders to identify and implement risk adjustment initiatives that align with organisational goals and objectives
Requirements:
- Proficient in risk adjustment strategy for Medicare and ACA lines of business
- Demonstrated understanding of HEDIS and STAR measures
- Knowledge of healthcare regulations and compliance requirements
- Familiarity with value-based care, provider incentive programs, and quality programs
- Excellent communication and interpersonal skills
- Intermediate Excel skills, PowerPoint (MS Suite)
- Strong analytical skills and experience with data analysis and reporting
Benefits:
- Competitive salary: $44.99 - $69.44 per hour
- Generous benefits package covering a wide range of programs to foster a sustainable culture of wellness
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