Director of Risk Adjustment & Quality Record Retrieval

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The Director of Risk Adjustment& Quality Record Retrieval is responsible for leading front-line record retrieval operations that support several top strategic priorities for Humana. These high-profile priorities include Risk Adjustment's Chart Review program, Risk Adjustment internal and external audits (e.g., CMS Risk Adjustment Data Validation [RADV] audits), quality initiatives such as HEDIS, and other projects as needed. The Director works collaboratively across the enterprise to ensure retrieval processes and outcomes are optimized and effectively communicated.
The Director of Risk Adjustment & Quality Record Retrieval leads a large-scale operation of 300 associates across the country focused on the successful retrieval of medical records for critical internal and external Risk Adjustment and Quality priorities. Humana's retrieval strategy is multi-faceted, leveraging both internal and external channels; this Director will be specifi...