The French Group has been engaged by a premier, substantial national health insurance carrier to identify an executive to lead their Medicare risk adjustment and reconciliation department. The Director will be responsible for developing the department's structure and developing it's long term strategy and direction. This individual will be responsible for all corporate initiatives related to the maximization of revenue and optimization of premium reconciliation with the Centers for Medicare Medicaid Services (CMS). This role will oversee Medicare enrollment and dis-enrollment, risk adjustment, and membership coding for all Medicare Advantage and Medicare Part D membership and will be responsible for crafting a strategy which directs scarce resources to priority physician offices maximizing return on investment. This is a highly visible role with a nationally recognized industry leader.
Suitable candidates will have extensive Medicare risk adjustment and reconciliation leadership experience and expert knowledge of CMS guidelines and regulations. BA/BS Finance and a minimum of ten years relevant experience is required. Excellent leadership skills, strong communication, and interpersonal skills are critical. PMI preferred. Travel required. Strong strategic planning skills required.
Contact: smcgovern@frenchgroup.com |
