Alpine Physician Partners

Program Manager

• Own the annual risk adjustment and Stars improvement program cycle across prospective and retrospective programs, visit-based campaigns, and gap closure workflows
• Build and manage program timelines and throughput; report progress to Alpine leadership and health plan partners
• Lead cross-functional workgroups spanning coding/HCC, clinical quality, IT, and analytics
• Manage program documentation and requirements, translating technical specifications into operational plans
• Liaise between coding/data teams and operational stakeholders on HCC capture, chart review, and gap identification workflows
• Manage vendor relationships and coordinate technical file exchange and integration needs
• Monitor RAF score trends and performance results and translate findings into operational action plans
• Coordinate risk adjustment data submission accuracy and EDS reconciliation
• Track HCC model version transitions and communicate operational and financial impacts
• Coordinate Star Ratings strategy across HEDIS, CAHPS, HOS, and medication adherence measures
• Partner with analytics teams on performance tracking, cut-point modeling, KPIs, and dashboards
• Serve as a point of contact with health plan Stars/quality teams
• Identify and escalate data integrity issues across claims, EHR, and supplemental data feeds
• Present performance results and program recommendations to executive leadership and payer partners
• Ensure compliance with CMS regulations, ICD-10-CM coding guidelines, and company policies
• Support RADV audit readiness and health plan data validation requests

Program Manager, Risk Adjustment – Stars