Executive Director of Risk Adjustment Greater New York City, NY Area

The Company is seeking an Executive Director of Risk Adjustment to lead the strategy and operational performance of enterprise-wide risk adjustment programs. The role oversees risk capture across provider networks, embedding documentation and coding practices into clinical workflows while ensuring regulatory compliance and audit readiness. Responsibilities include guiding coding, chart review, documentation improvement, education, analytics, and reporting programs; partnering with provider, clinical, finance, and compliance leaders; and improving workflows and provider engagement. The Executive Director will also lead multidisciplinary teams and track performance in risk accuracy, coding quality, gap closure, financial outcomes, and audit results. Candidates should have at least 10 years of experience in risk adjustment, coding, or value-based care, including work with provider organizations in risk-bearing models. Deep expertise in CMS-HCC, ICD-10, and documentation standards is required, along with a solid understanding of regulatory audits and compliance frameworks. The role calls for strong strategic leadership, analytical, and partnership skills to translate performance insights into effective programs and operational improvements.

Hiring Company

UnitedHealth Group