Senior Director, Risk Performance

Summary

Join Aledade as the Senior Director of Risk Performance and lead the development and execution of strategies for complete and accurate diagnosis documentation and risk adjustment. Shape technical services and build Aledade’s reporting infrastructure to support data-driven decision-making. Collaborate across departments to improve operational execution, develop strategies to enhance risk adjustment market capture, and drive continuous improvement. Lead strategic projects in Risk workstreams, including CDI, revenue integrity, and vendor management. Partner with the Clinical Engagement Team and leverage clinical expertise to support strategic initiatives. Collaborate with Legal and Compliance teams to ensure risk initiatives align with regulatory standards. Manage direct reports across multiple workstreams, including CDI, Risk Intervention Strategy (RIS), Performance, and Operations. This role requires significant experience in healthcare, risk adjustment, and program management.

Requirements

• Bachelor’s degree in Healthcare Adm, Business or IT (or appropriate equivalent training and experience)
• 10+ years payer/healthplan/value based care company including Medicare and Commercial
• 7 + years Medicare risk adjustment including setting strategy for multiple Risk workstreams is a requirement, these may include CDI, IHAs, risk analytics, vendor decisions and management, suspect logic or other provider suggestion tools
• Demonstrated, well-rounded experience supporting or leading Risk-based initiatives
• Demonstrated knowledge and experience with risk adjustment methodologies such as HCC, 3M, Milliman, etc
• 7+ years of program management, project leadership and execution experience in a healthcare or product related setting
• 7+ years of management experience
• Demonstrated customer-centric approach to work within experience
• Should be an agile user of Google Suites (or microsoft equivalent), analytical dashboards (such as Tableau), customer relationship management software (or other complex databases)

Responsibilities

• Collaborate within and across departments for platform improvements for operational execution by the Field
• Develop strategies and tactics to improve risk adjustment market capture through technology and product enhancements
• Drive continuous improvement across departments (product, tech, analytics, Aledade plus and other departments) through influence and inspiration
• Lead strategic projects in Risk workstreams, as requested by SVP of Affordability and Risk
• These may include but are not limited to the areas of Clinical Documentation Integrity (CDI), revenue integrity, vendor management, and decisions based on data in support of Performance projects
• In the Risk Key Result (led by SVP of Affordability and Risk), expect to lead at least one sub-KR such as improving performance in customer interactions with suspected chronic conditions (visits, views, resolving, redocumentation)
• Partners closely with the Clinical Engagement Team (CET), including Regional Medical Directors, to assess and operationalize feedback related to platform enhancements
• Where applicable, leverages clinical expertise to lead or support strategic initiatives aligned with the individual’s clinical training (e.g., nurse, advanced practitioner, physician)
• Collaborates closely with Legal and Compliance teams to ensure risk initiatives align with regulatory standards and Aledade’s patient-first approach
• Supports the development of condition suspecting strategies that enable timely and accurate diagnoses—improving patient outcomes and reducing total cost of care
• Manages direct reports across multiple workstreams, which may include CDI, Risk Intervention Strategy (RIS), Performance, and Operations
• Team assignments may evolve over time as organizational needs shift or as Aledade brings on additional leadership
• Assigned teams reporting to Sr Director will be determined by experience of the hire and may evolve over time as more Aledade-experience is gained
• If Aledade adds a VP of Risk Performance, shifting of which workstreams report to VP vs Sr Director is to be expected

Preferred Qualifications

• MBA, MHA or other Master’s level training in health, business or IT
• 10+ years of program management, project leadership and execution experience in a healthcare or product related setting
• Demonstrated leadership ability in prior workplace, including running teams and managing a high profile portfolio, with internally and externally facing representation responsibilities
• Advanced Analytics: SQL, PowerBI, SAS

Benefits

• Flexible work schedules and the ability to work remotely are available for many roles
• Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
• Robust time-off plan (21 days of PTO in your first year)
• Two paid volunteer days and 11 paid holidays
• 12 weeks paid parental leave for all new parents
• Six weeks paid sabbatical after six years of service
• Educational Assistant Program and Clinical Employee Reimbursement Program
• 401(k) with up to 4% match
• Stock options