Risk Adjustment Program Manager (Defined Term)

This is a Defined Term position, which is designated by the Alliance and is a position of limited duration. Defined Term employees are usually hired to work in a specific department on specific long-term project work until the work is completed or to a specific end date not to exceed December 31, 2026. This is a Defined Term and fully benefited position.

We have an opportunity to join the Alliance as a Risk Adjustment Program Manager in the Risk Adjustment Department.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Risk Adjustment Director, this position :

• Develops, manages, implements, and supports Risk Adjustment programs and manages Risk Adjustment Department activities
• Manages small- to large-scale projects that advance business outcomes to achieve strategic objectives
• Acts as a risk adjustment subject matter expert and resource

ABOUT THE TEAM

Risk Adjustment is a growing, specialized team that plays a critical role in ensuring accurate coding, appropriate reimbursement and data-driven insights that support the broader organizational goals of our health plan. Our team collaborates closely with internal and external partners to optimize risk adjustment performance across our future Medicare and current Medi-Cal programs. We are passionate about using data to improve our members' health outcomes, support the success of our provider partners, and ensure regulatory alignment.

THE IDEAL CANDIDATE

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here .

Ability to :

Education and Experience :

OTHER INFORMATION

The full compensation range for this position is listed by location below.

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

Typical areas in Zone 1 : Bay Area, Sacramento, Los Angeles area, San Diego area

Typical areas in Zone 2 : Fresno area, Bakersfield, Central Valley (with the exception of Sacramento), Eastern California, Eureka area

Zone 1 (Monterey, San Benito and Santa Cruz)

$110,160 — $176,259 USD

Zone 2 (Mariposa and Merced)

$100,246 — $160,410 USD

OUR BENEFITS

Available for all regular Alliance employees working more than 30 hours per week.Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.

ABOUT US

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet .

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.