Associate Director, Risk Adjustment and Quality Strategy (Woburn)

Evolent Health in Woburn, MA

  • Industry: Executive Management - Administrative/Operational Support
  • Type: Full Time
  • $98,040.00 - 167,060.00
position filled

Associate Director, Risk Adjustment and Quality Strategy

Its Time For A Change Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely about 40% in year-over-year revenue growth in 2018 . Are we recognized? Definitely. We have been named one of Beckers 150 Great Places to Work in Healthcare in 2016, 2017, 2018 and 2019, and One of the 50 Great Places to Work in 2017 by Washingtonian. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If youre looking for a place where your work can be personally and professionally rewarding, dont just join a company with a mission. Join a mission with a company behind it.

Who Youll Be Working With:

The Associate Director will be on the Risk, Adjustment, STARS, Quality, (RASQ) team. Youll be working directly with our strategy, implementation, and service operations teams to implement and lead the quality measure strategy, performance monitoring, and development of quality campaigns to support a specific line of business.

What Youll Be Doing:

  • Serve as an Evolent Quality Subject Matter Expert to internal and external stakeholders across a specified line of business and quality programs (Medicare Advantage, Medicaid, Commercial, and government and commercial payer partnerships)
  • In conjunction with the RASQ Account Managers and client partners, develop a Quality measure strategy specific to each markets local priorities ensuring compliance with regulatory and accreditation requirements.
  • Deliver on organization and client Quality goals in a highly matrixed work environment
  • Steer centrally-administered Quality campaigns to result in efficient and effective outreach efforts
  • Reviews, interprets and presents Quality measure reports to internal stakeholders, recommending enhancements as needed
  • Proactively engage with market teams to review Quality strategy and initiative progress
  • Build relationships with all internal market leads and client leaders, building credibility and garnering support for network Quality campaigns
  • Collaborate with the Central Risk Adjustment, Quality and Network Performance team to monitor and track progress of central operations, escalate risks and propose solutions to cross-client issues
  • Maintain knowledge of current professional, regulatory, and industry trends to consult with internal and external stakeholders on standards and best practices.
  • Support prospective client presentations on the Quality value proposition in conjunction with business development efforts

The Experience Youll Need (Required):

  • Bachelor's Degree and/or Master Preferred
  • 5-7 years of experience with analyzing HEDIS, CAHPS, HOS and Medicare Star or related clinical quality rating data
  • Past health plan or managed care environment highly preferred, including minimum of 3 years of Medicare, Medicaid, and/or dual eligible quality management experience in a managed care setting
  • 3+ years of experience in managing large enterprise-level programs
  • 3+ years of experience in Managed Care, Payer/Provider/Health Plan and/or Health system management
  • Professional experience designing a quality strategy with a large, complex and integrated health care delivery system.
  • Ability to help design effective solutions to work collaboratively with client management
  • Ability to travel up to 20% of the time.

Finishing Touches (Preferred):

  • Experience with payers and billing including knowledge of ICD-10 coding guidelines
  • Strong client management experience, having demonstrated an ability to communicate effectively and partner with client executives
  • Demonstrated track record for achieving performance results
  • Ability to analyze and present data
  • Excellent written and oral presentation skills, with the ability to engage, inspire, build credibility and engender trust across all levels of an organization

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.

Get notified about new jobs that match you, and let Evolent Health know youre interested!

Associated topics: administrative coordinator, administrative officer, administrative support, asso, associate, beverage, chief operations officer, document, front desk, records management

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