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Baylor Scott & White Health
University Park, Texas
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Director, Risk Adjustment
The Director of Risk Adjustment (RA) coordinates and oversees the analysis, monitoring, reporting, and forecasting of RA activities for the Government Programs lines of business, such as Medicare Advantage, Commercial Individual and Small Group and Medicaid member populations. This position keeps abreast of new RA legislation and regulations and is responsible for analyzing and communicating the potential impact to the rest of Community Health Choice. This position leads the alignment of all Risk Adjustment initiatives occurring within other functional teams such as Quality, Compliance, Operations, Legal, and Actuarial to improve the completeness and accuracy of RA data submitted to CMS and HHS. The Director ident
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