Director, Risk Adjustment and Government Programs

The Southeast Permanente Medical Group (TSPMG)/Kaiser Permanente

is eager to announce an opening for Director, Risk Adjustment and Government Programs.

Description

Directs the delivery of large-scale programs with multiple workstreams and strategic goals, with accountability for Risk Adjustment Program outcomes. In partnership with the Physician Director, provides strategic leadership, operational execution, and financial oversight of risk adjustment activities. Leads program teams, ensures accountability, and supports resource planning. Identifies and mitigates risks, partners across clinical and operational teams, and ensures regulatory compliance while driving data-driven performance improvement and stakeholder alignment.

Job Functions

• Develops and executes risk adjustment strategy for Medicare Advantage and ACA populations.
• Builds stakeholder alignment, communicates effectively with leadership, and drives long-term program goals.
• Oversees end-to-end risk adjustment operations, translating strategy into execution plans, managing resources, resolving issues, and ensuring regulatory compliance.
• Establishes KPIs, KAIs, and dashboards.
• Monitors performance, mitigates risks, and drives continuous improvement and provider engagement.
• Leads outreach strategies for member engagement, coordinates with internal teams and vendors, and oversees vendor performance and integration.

Education

• Bachelor’s degree: in healthcare administration, business administration, or related field (required)
• Master’s degree: in healthcare administration, business administration, or related field (preferred)
• PMP: or equivalent certification
• Lean / Six Sigma: certification

Work Experience

• Minimum: 4+ years leadership experience
• 10+ years: healthcare or health plan experience (7+ with advanced degree)
• 10+ years: project/program management experience
• 3+ years: managing budgets

Knowledge and Skills

• Knowledge of medical terminology and clinical processes
• Strong financial and analytical skills
• Ability to collaborate across clinical and operational teams
• Strong communication and presentation skills
• Proficiency in Microsoft Office Suite

Preferred

• Experience in value-based care and population health
• Coding or revenue cycle experience
• Experience with EpicCare Ambulatory and Epic PB
• Knowledge of risk adjustment regulations
• Experience with Convergent Medical Terminology (CMT)
• Advanced Microsoft Office expertise

Contact Information

Please e-mail: Ross Artley, ross.artley@kp.org, for more information.

About TSPMG

The Southeast Permanente Medical Group (TSPMG) is one of Georgia’s largest independent, physician-owned, multi-specialty medical groups. More than 600 physicians and 200 associate practitioners work together in a unique integrated care model to provide high-quality care to over 315,000 Kaiser Permanente members. Care is delivered at 26 medical offices featuring state-of-the-art equipment, labs, imaging services, and pharmacies. We also provide surgical services and around-the-clock care at some of the area’s top hospitals.

Benefits of Working with TSPMG

TSPMG offers a competitive salary, a generous retirement package, paid time off, health, dental, vision, and life insurance, long and short-term disability, relocation allowance, and more. We also offer numerous clinical and non-clinical learning opportunities and physician leadership development.

About Atlanta

Atlanta, our home for more than 30 years, is a thriving metropolis that blends southern charm with modern art, music and culture. Learn more about our beautiful southern city at www.atlanta.com.

Equal Opportunity Employer

We are an equal opportunity employer. All applicants will be considered for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran or disability status. We maintain a drug and nicotine free workplace and perform pre-employment substance abuse testing.