Director of Revenue Cycle Management
Rhythm
Senior Manager, Risk Adjustment Provider Enablement
Homeward
full-time
Posted on:
Origin: • 🇺🇸 United States • Illinois
Visit company websiteSalary
💰 $117,000 - $140,000 per year
Job Level
Senior
About the role
- Homeward is rearchitecting the delivery of health and care in partnership with communities, focusing on rural America and Medicare-eligible beneficiaries.
- Join us in transforming care delivery for rural America as Risk Adjustment Provider Enablement, Senior Manager to lead external risk adjustment program for contracted providers.
- Serve as the point of contact for all contracted practices participating in Homeward’s Risk Adjustment Enablement program.
- Drive deployment and scaling of provider education, performance monitoring, and feedback mechanisms; operationalize RA enablement model including scorecard delivery, documentation feedback, and provider-facing education.
- Lead discussions with payers on risk gap data, coding trends, and incentive design; oversee supplemental file submissions and claims analysis.
- Monitor provider recapture rates and collaborate with data team to evolve dashboards and workflows.
- Partner with internal stakeholders to refine workflows, launch pilot programs, and build Homeward’s RA operations playbook.
Requirements
- 6+ years of experience in Medicare Advantage risk adjustment, provider enablement, clinical education, or healthcare operations.
- 3+ years of experience leading teams in a fast-paced, performance-driven environment.
- Certified Risk Adjustment Coder (CRC) or similar AAPC/AHIMA certification.
- Expertise in ICD-10-CM coding, CMS-HCC models, and OIG/CMS regulatory compliance.
- Deep knowledge of provider workflow dynamics, documentation improvement strategies, and claims submission processes.
- Strong interpersonal skills, with the ability to influence and coach clinical and non-clinical stakeholders.
- Familiarity with EMR systems and risk adjustment analytics platforms.
- Proven ability to lead cross-functional projects, synthesize data into action, and build scalable solutions from the ground up.
