IntraCare

Risk Adjustment Manager

IntraCare  •  Carrollton, TX (Onsite)  •  12 days ago
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Job Description

About IntraCare

IntraCare Health Center (DFW Healthcare MSO) proudly serves the greater Dallas-Ft. Worth and Phoenix, Arizona areas with a decade of excellence in value-based care and clinic operations. Our outstanding leadership and commitment to service have established us as a trusted partner for multiple healthcare organizations.

At IntraCare, we believe in more than just a job; we offer a vibrant workplace where culture and collaboration thrive. We are dedicated to fostering an inclusive environment that values diverse perspectives and promotes respectful dialogue. Our approach encourages innovation and healthy debate, as we seek to build a team of dedicated partners who contribute to our collective success. We are passionate about empowering our employees, helping them grow both personally and professionally. This unwavering focus on team culture and individual development is the cornerstone of our ongoing achievements.

Position

The Risk Adjustment Manageris responsible fordesigning, executing, and continuously improving the organization’s Medicare and Medicare Advantage risk adjustment strategy. This role ensuresaccurate, compliant capture of patient acuity while driving provider engagement, operational excellence, and financial performance across employed and affiliate clinics.This is astrategy + execution role, bridgingclinical operations, analytics, providers, coding teams, and health plan partners.

Position may be remote with some travelrequired.

Key Responsibilities

Risk Adjustment Strategy & Performance

  • Own the end-to-endimplementation ofMedicare and Medicare Advantage risk adjustment strategy, including prospective, concurrent, and retrospective models
  • Establish annual RAF targets, forecasts, and performance monitoring cadence
  • Translate CMS HCC guidance into actionable clinical and coding workflows
  • Monitor coding intensity, suspect capture rates, and year-over-year RAF trends

Provider Enablement & Engagement

  • Partner with providers to improve documentation accuracy and chronic condition capture
  • Lead provider education on risk adjustment, HCCs, and compliant documentation practices
  • Collaborate with Provider Relations and Clinical Leadership to embed workflows into daily practice
  • Support employed and affiliate clinics with tailored engagement strategies

Operational Oversight

  • Oversee coding workflows across internal and offshore teams
  • Ensure quality assurance processes are in place for coding accuracy and compliance
  • Coordinate chart review programs, vendor partnerships, and audit readiness
  • Maintain CMS compliance and audit-defensible documentation standards

Data, Analytics & Reporting

  • Partner with analytics teams to develop RAF dashboards and performance reporting
  • Interpret claims, encounter, and EMR data toidentifygaps and opportunities
  • Provide regular performance updates to executive leadership
  • Support payer reporting and reconciliation efforts

Cross-Functional Leadership

  • Serve as the risk adjustment subject matter expert across the organization
  • Collaborate with Quality, Care Management, Finance, and IT teams
  • Support contract strategy and value-based care financial modeling
  • Drive continuous improvement initiatives and best-practice standardization

Experience

Required

  • Bachelor’s degree (clinical background preferred)
  • 5+ years of experience in Medicare and Medicare Advantage risk adjustment
  • Strong working knowledge of CMS HCC models and documentation guidelines
  • Experience supporting provider education and clinical workflow optimization
  • Proven ability to manage distributed or offshore coding teams
  • Strong analytical, communication, and stakeholder management skills
  • US-based with availability to support provider and leadership engagement

Preferred

  • CRC, CPC, CCS, RN, or equivalent credential
  • Experience in value-based care, ACOs, or delegated risk arrangements
  • Experience with Revenue Cycle Management
  • Experience supporting both employed and affiliate provider networks
  • Familiarity with RAF forecasting andfinancial impactmodeling
IntraCare

About IntraCare

The current healthcare system is confusing and impersonal. Patients avoid regular checkups because they feel uncomfortable, unheard, or misunderstood. IntraCare seeks to personalize the patient experience by empowering doctors with the resources to give their patients individualized attention. The need to be healthy is one of the few things we all have in common. The system by which we administer and receive healthcare should reflect that unity. IntraCare helps connect patients, doctors, and medical programs to provide people-focused healthcare.Many providers can relate to healthcare as a battlefield. Providers find themselves caught between competing priorities and needs. Although providers enter the healthcare field passionate about their work, they are soon obstructed by the details of owning an independent practice. IntraCare simplifies the patient care process and empowers providers to do what they love. By partnering with us in creative, highly aligned ways, IntraCare will increase the quality of service and accessibility in our partners’ communities. As we build on ten years of excellence in value-based care and connect with a high-quality network of over 200 experienced providers, we will manage an excellent system of care that is inclusive and integrated to help patients across the nation. Everyone deserves access to accessible and affordable healthcare regardless of race, religion, nationality, or financial status. We want to advance the health industry by partnering with physicians to provide personalized, intentional care in communities that have been overlooked.

Industry
Healthcare & Social Services
Company Size
51-200 employees
Headquarters
Addison, Texas
Year Founded
2013
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