SENIOR WHOLE HEALTH (SWH) is a rapidly growing Medicare Advantage Special Needs Plan, pioneering the way health care is provided to low-income seniors. Our mission is to maximize the quality of life, health and independence for our Members. We are looking for a dynamic Director, Risk Adjustment to join our growing company in Cambridge, Massachusetts.

The Director, Risk Adjustment is responsible for maintaining current practices in revenue accuracy and risk adjustment as well as developing new and innovative initiatives.

Responsibilities include, but are not limited to:

•Develop and implement new strategies for improving revenue accuracy •Monitor current risk adjustment practices and capitalize on improvement opportunities •Work with analysts to report on productivity and impact of each initiative •Implement and optimize healthcare system, Voyager, for analytics •Manage staff, including the Risk Adjustment Coding Manager who oversees coders responsible for retrospective review Candidate will have an understanding of managed care. 3-5 years in a managed Medicare/Medicaid preferred. Knowledge of CMS risk adjustment a plus. Strong communication and documentation skills. Proven ability to think through creative solutions to business problems.

We offer a competitive salary and excellent benefits. Please forward resumes to hr@seniorwholehealth.com or fax to (617) 252-6303.