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Senior Director, Risk Adjustment Market Performance
Centene Corporation. Provide executive leadership for risk adjustment performance across markets and lines of business .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in risk adjustment operations, provider performance improvement, and healthcare analytics, with a strong focus on developing governance frameworks and executive reporting to drive organizational performance in value-based care settings.
Highest-signal resume keywords
Risk Adjustment OperationsProvider Performance ImprovementHealthcare AnalyticsExecutive ReportingCross-Functional Initiative Management
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Risk Score CaptureCoding AccuracyDocumentation QualityChart RetrievalPerformance Review ProcessesRoot-Cause AnalysisPerformance Improvement StrategiesHealthcare Reimbursement MethodologiesValue-Based CarePopulation Health
Soft Skills
Executive LeadershipRelationship BuildingInfluencing Across Matrixed OrganizationsCollaborationCommunication
Tools & Technologies
DashboardsAnalytics ToolsGovernance Frameworks
Certifications & Qualifications
PMPLean Six SigmaCPHQ
Industry Keywords
Healthcare OperationsManaged CareProvider EngagementMedicaidMedicareMarketplaceCommercial
Tech Stack
Tools & technologiesPMP
About the role
Key responsibilities & impact- Provide executive leadership for risk adjustment performance across markets and lines of business
- Serve as the primary liaison between Enterprise Risk Adjustment and market leadership
- Lead market risk adjustment strategies and initiatives to achieve enterprise performance objectives
- Establish and monitor targets for risk score capture, coding accuracy, documentation quality, chart retrieval, and provider performance
- Identify and prioritize high-impact provider organizations and strategic partners
- Build executive-level relationships with provider organizations and integrate risk adjustment priorities into value-based care and population health strategies
- Direct collaboration across risk adjustment, provider engagement, quality, network management, actuarial, clinical operations, analytics, and external partners
- Establish governance, accountability frameworks, and performance review processes
- Develop executive reporting, dashboards, and action plans to measure results and address performance gaps
- Conduct risk assessments, root-cause analyses, and targeted interventions
- Advise enterprise and market leadership on provider investments, resource allocation, operating model enhancements, and best practices
- Perform other duties as assigned
- Comply with all policies and standards
Requirements
What you’ll need- Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
- Bachelor's Degree in Business Administration, Healthcare Administration, Finance, Analytics, Public Health, or related field, or equivalent experience required
- 8+ years experience in healthcare operations, risk adjustment, managed care, provider performance, value-based care, analytics, clinical operations, or related healthcare field required
- 3+ years management experience managing complex cross-functional initiatives and driving organizational performance required
- 5+ years experience presenting operational performance, business results, and strategic recommendations to executive leadership required
- Demonstrated expertise in risk adjustment operations, provider performance improvement, coding and documentation programs, healthcare analytics, and managed care required
- Experience supporting multiple lines of business, including Medicaid, Medicare, Marketplace, and Commercial preferred
- Experience developing governance frameworks, executive reporting, accountability models, and performance improvement strategies preferred
- Knowledge of provider engagement, value-based care, population health, and healthcare reimbursement methodologies preferred
- Proven ability to influence across matrixed organizations and lead enterprise-to-market performance initiatives that drive measurable results preferred
- Master's Degree in Business Administration, Healthcare Administration, Public Health, Finance, or related field preferred
- PMP, Lean Six Sigma, CPHQ, or related healthcare operations, performance improvement, or project management certification preferred
Benefits
Comp & perks- Competitive pay
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation
- Diversity-focused equal opportunity employer