Job description
The Senior Director of Risk Performance will lead the development and execution of Aledade’s strategy for complete and accurate diagnosis documentation and risk adjustment. This role is responsible for shaping technical services, and building out and advancing Aledade’s reporting infrastructure to support high-quality, data-driven decision-making.
Primary Duties:
- Collaborate within and across departments for platform improvements for operational execution by the Field. Develop strategies and tactics to improve risk adjustment market capture through technology and product enhancements. Drive continuous improvement across departments (product, tech, analytics, Aledade plus and other departments) through influence and inspiration.
- Lead strategic projects in Risk workstreams, as requested by SVP of Affordability and Risk. These may include but are not limited to the areas of Clinical Documentation Integrity (CDI), revenue integrity, vendor management, and decisions based on data in support of Performance projects. In the Risk Key Result (led by SVP of Affordability and Risk), expect to lead at least one sub-KR such as improving performance in customer interactions with suspected chronic conditions (visits, views, resolving, redocumentation).
- Partners closely with the Clinical Engagement Team (CET), including Regional Medical Directors, to assess and operationalize feedback related to platform enhancements. Where applicable, leverages clinical expertise to lead or support strategic initiatives aligned with the individual’s clinical training (e.g., nurse, advanced practitioner, physician). Clinical credentials are not required for the role.
- Collaborates closely with Legal and Compliance teams to ensure risk initiatives align with regulatory standards and Aledade’s patient-first approach. Supports the development of condition suspecting strategies that enable timely and accurate diagnoses—improving patient outcomes and reducing total cost of care.
- Manages direct reports across multiple workstreams, which may include CDI, Risk Intervention Strategy (RIS), Performance, and Operations. Team assignments may evolve over time as organizational needs shift or as Aledade brings on additional leadership. Assigned teams reporting to Sr Director will be determined by experience of the hire and may evolve over time as more Aledade-experience is gained. If Aledade adds a VP of Risk Performance, shifting of which workstreams report to VP vs Sr Director is to be expected.
Minimum Qualifications:
- Bachelor’s degree in Healthcare Adm, Business or IT (or appropriate equivalent training and experience)
- 10+ years payer/healthplan/value based care company including Medicare and Commercial
- 7 + years Medicare risk adjustment including setting strategy for multiple Risk workstreams is a requirement, these may include CDI, IHAs, risk analytics, vendor decisions and management, suspect logic or other provider suggestion tools.
- Demonstrated, well-rounded experience supporting or leading Risk-based initiatives. .Demonstrated knowledge and experience with risk adjustment methodologies such as HCC, 3M, Milliman, etc.
- 7+ years of program management, project leadership and execution experience in a healthcare or product related setting.
- 7+ years of management experience
- Demonstrated customer-centric approach to work within experience
- Should be an agile user of Google Suites (or microsoft equivalent), analytical dashboards (such as Tableau), customer relationship management software (or other complex databases).
Preferred Qualifications:
- MBA, MHA or other Master’s level training in health, business or IT
- 10+ years of program management, project leadership and execution experience in a healthcare or product related setting.
- Demonstrated leadership ability in prior workplace, including running teams and managing a high profile portfolio, with internally and externally facing representation responsibilities
- Advanced Analytics: SQL, PowerBI, SAS
Physical Requirements:
- Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.
- Travel: 10-25%
Who We Are:
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we’ve become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you’re eager to join a collaborative, inclusive and remote-first culture - you’ve come to the right place.
What Does This Mean for You?
At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much more!
At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
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