Hybrid flex (minimum of two days in the office per week)
10+ years risk adjustment experience
Medicare advantage and aca marketplace expertise
5+ years people leadership managing managers
Blue Cross NC is seeking an Assistant Vice President of Risk Adjustment to lead and enhance their Risk Revenue Program across various health plan segments. The role requires extensive experience in risk adjustment, strong leadership skills, and a collaborative approach to drive compliance and performance initiatives
Matching Summary
Match Score: 85
Blue Cross NC is seeking an Assistant Vice President of Risk Adjustment to lead and enhance their Risk Revenue Program across various health plan segments. The role requires extensive experience in risk adjustment, strong leadership skills, and a collaborative approach to drive compliance and performance initiatives.
Salary
Base: $210,268.00 - $336,430.00; Bonus: Annual Incentive Bonus based on corporate and individual performance; Benefits: 401(k) match, PTO, health benefits, wellness programs
Skills & Requirements
Must-have
10+ years Risk Adjustment experience
Medicare Advantage and ACA Marketplace expertise
5+ years people leadership managing managers
Deep knowledge of CMS HCC and RADV audits
ICD-10-CM coding guidelines and documentation standards
Nice-to-have
Experience leading both Medicare and ACA in same org
Prior single-state or regional health plan experience
Vendor management and RFP experience
Integration into value-based care strategies
Success navigating regulatory model transitions
Key Requirements
Bachelor's degree required; Master's preferred
10+ years progressive Risk Adjustment experience
5+ years people leadership experience
Direct experience with Medicare Advantage Risk Adjustment
Direct experience with ACA Marketplace Risk Adjustment