[Remote] Vice President, Risk Adjustment Program Operations & Data Integrity

Note: The job is a remote job and is open to candidates in USA. Health Net Health Plan of Oregon, Inc. is part of Centene, which is transforming the health of communities. The Vice President of Risk Adjustment Program Operations & Data Integrity will provide operational leadership for the Corporate Risk Adjustment program, overseeing compliance and leading enterprise-wide operations while ensuring data integrity and regulatory alignment.ResponsibilitiesProvide operational leadership for Centene's Corporate Risk Adjustment program operations and its subsidiariesOversee compliance with Risk Adjustment data integrity and validation audit processLead enterprise-wide Risk Adjustment operations for coding and external audits, ensuring consistent execution while addressing market, product, and regulatory variationLead and develop high performing, multi-disciplinary teams through complex change, reinforcing accountability, engagement, and resultsDrive enterprise change management through standardized processes, tools, and controls that improve scalability, quality, and complianceOversee encounter data submissions and reconciliation to ensure data completeness, accuracy, and regulatory alignmentEffectively communicate risk, organizational impact and progress towards achieving goalsEstablish strong governance and oversight for Risk Adjustment compliance, including RADV and other regulatory and internal auditsWork with local market teams as necessary to support Enterprise Risk Adjustment programs and educationEnsure disciplined oversight of vendor performance, holding partners accountable to quality, timeliness, and contractual expectationsPerforms other duties as assignedComplies with all policies and standardsSkillsBachelor's degree in health information management, Nursing, Healthcare Administration, Business, or related field required10+ years of progressive leadership experience in Risk Adjustment, medical coding, healthcare compliance, or related regulated healthcare operationsDemonstrated experience leading large teams of certified coders, auditors, and quality professionals across multiple programs or marketsDeep knowledge of CMS Risk Adjustment requirements, ICD 10 CM coding standards, RADV audits, and encounter data submissionsProven record of establishing coding governance, quality assurance, and audit readiness programs in highly regulated environmentsExecutive level people leadership experience, including workforce development, performance management, and leading teams through changeOr equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this positionAdvanced degree preferredBenefitsCompetitive payHealth insurance401K and stock purchase plansTuition reimbursementPaid time off plus holidaysA flexible approach to work with remote, hybrid, field or office work schedulesTotal compensation may also include additional forms of incentivesBenefits may be subject to program eligibilityCompany OverviewOur mission at Health Net Health Plan of Oregon, Inc., “Health Net” is to transform the health of communities, one person at a time. It was founded in undefined, and is headquartered in Tigard, Oregon, US, with a workforce of 201-500 employees. Its website is http://www.healthnetoregon.com.