VP, Risk Adjustment Performance

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Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Vice President, Risk Adjustment Performance is the organization's most senior leader accountable for the strategy, execution, and optimization of all Risk Adjustment programs across the Medicare Advantage business - owning both the long-term vision and the day-to-day performance of the function. This executive partners closely with Clinical, Quality, Analytics, Finance, Provider Relations, and Member Experience teams to build and execute a unified Risk Adjustment strategy that maximizes revenue accuracy, ensures CMS compliance, and demonstrates the true complexity of the members the organization serves. Leading a dedicated team of managers, data analysts, and risk coders, the VP translates federal regulatory requirements, market intelligence, and data-driven insights into action - driving provider engagement, refining coding and documentation practices, and achieving measurable improvement in RAF scores, HCC accuracy, and program performance. This role is critical to the organization because Risk Adjustment is a primary driver of Medicare Advantage revenue integrity - and the VP's ability to align clinical, operational, and analytical functions around a shared performance agenda directly determines the organization's financial position and long-term competitiveness in the MA market. Job Responsibilities: Develop and Execute the Multi-Year Risk Adjustment Business Plan. Own the enterprise Risk Adjustment strategy - building and executing a multi-year business plan that analyzes the interrelationships of products, operations, market dynamics, and program performance to achieve sustained improvement in RAF accuracy and revenue optimization. Establish, track, and drive performance targets and KPIs across all Risk Adjustment programs, ensuring the organization moves from reactive compliance to proactive, forward-looking performance management. Lead Provider Network Engagement for Risk Adjustment Performance. Design and execute provider engagement strategies that directly improve HCC coding accuracy, clinical documentation quality, and Risk Adjustment performance across the provider network. Build structured, trust-based relationships with provider partners - educating on coding standards, identifying gaps, and creating feedback loops that make documentation improvement sustainable and clinically meaningful rather than administratively burdensome. Build, Lead, and Develop the Risk Adjustment Team. Direct and develop a high-performing team of managers, data analysts, and risk coders - setting clear performance expectations, fostering a culture of accountability and continuous improvement, and investing in the professional growth of every team member. Ensure the team has the tools, training, market data, and operational infrastructure needed to execute the Risk Adjustment strategy at scale across all markets. Maintain Expert Regulatory and Competitive Intelligence. Serve as the organization's foremost authority on CMS regulations, federal legislative changes, industry trends, and best practices in Medicare Risk Adjustment - providing timely, accurate, and actionable intelligence that enables the organization to stay ahead of regulatory shifts and competitive threats. Analyze and communicate the business implications of policy changes and market dynamics to senior leadership, providing recommendations that protect and optimize the organization's Risk Adjustment posture. Drive Cross-Functional Governance and Strategic Alignment. Lead a structured hierarchy of cross-functional steering meetings and workgroups - spanning Pharmacy, HEDIS, CAHPS, HOS, Operations, Provider Network, and Analytics - to ensure Risk Adjustment strategies are integrated into the broader Medicare performance model and that synergies across programs are identified and captured. Serve as the primary Risk Adjustment voice in enterprise strategy discussions, advocating for Medicare business interests in cross-functional initiatives and investment decisions. Leverage Data and Analytics to Drive Performance Improvement. Partner with Analytics, Finance, and IT teams to build and maintain the data infrastructure, reporting tools, and analytical capabilities required to identify Risk Adjustment opportunities, measure program effectiveness, and inform strategic decisions at every level of the organization. Ensure R

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