Director of Risk Management and Revenue Integrity

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  "Title": "Director of Risk Management and Revenue Integrity",
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          "Code": "TN",
          "Name": "Tennessee"
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          "Code": "USA",
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  "PostedDate": "2025-12-26T13:35:32.918Z",
  "JobCategoryName": "Claims Processing",
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  "BriefDescription": "JOB SUMMARY:\nResponsible for managing the Medicare Advantage risk adjustment process and encounter data processing (EDPS) in accordance with CMS regulations.  The Director of Risk Management is responsible for the timely and accurate collection, flow and processing of data for risk adjustment activities. This role will establish, monitor, and maintain the processes and systems that collect and process the data from claims, encounters, electronic medical records, medical record coding, and other supplemental data sources. This role acts as the risk adjustment program subject matter expert and works closely with other areas of health plan operations and programs, ensuring risk adjustment data operations are administered accurately, timely and in compliance with CMS regul",
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  "RequisitionNumber": "DIREC026057"
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