Vice President HQRI Operations About the Company Influential organization in the health & wellness industry
Industry
Insurance
Type
Public Company
Founded
1964
Employees
10,001+
Categories Business ServicesInsuranceHealth and WellnessHealthHealth CareHospitalsKentuckyLife and HealthManaged CareHealth InsuranceLouisvilleVenture CapitalHealth & WellnessFinance Business Classifications B2C About the Role The Company is seeking a Vice President (VP) for HQRI Operations to lead strategic initiatives that optimize risk adjustment operations and deliver quality outcomes with a focus on Medicare and Medicaid strategy. The VP will be responsible for creating and owning the strategic plan for enterprise risk adjustment operations, leading a large multi-level organization, and coordinating with various internal and external partners. Key responsibilities for this executive role include oversight of all operations within risk adjustment, such as medical record retrieval, coding operations, management of multiple vendors, encounter submissions, and dual eligible outreach. The successful candidate will be expected to have extensive leadership experience in the healthcare industry, particularly in risk adjustment operations, and a proven track record of success in a highly matrixed environment.
The ideal candidate will have a Bachelor's degree in a related field, with a Master's degree highly desired, and at least 10 years' experience in the healthcare industry. In addition to the educational and experience requirements, the VP should possess in-depth knowledge of the health insurance industry, Medicare operations, and a strong understanding of compliance and legal guidelines. The role demands a leader with excellent communication skills, the ability to build strategic relationships, and a collaborative mindset to engage diverse stakeholders. The VP will be a central figure in the company's mission to help people achieve lifelong well-being, and as such, a commitment to the values of the organization and a focus on the health and well-being of the community are essential.
Hiring Manager Title
Associate Vice President - Risk Adjustment & Prospective Programs
Travel Percent
20%
Functions Medical Care/Hospital AdministrationOperationsStrategy
