Risk Program Delivery Professional

The In-Office Provider Programs organization within Risk Adjustment delivers products that help physicians provide optimal patient care and improve the accuracy of clinical documentation. Its portfolio includes both in-house and vendor solutions, with a focus on expanding analytics-driven and interoperable capabilities.

The Senior Program Delivery Professional is responsible for execution and operational performance outcomes for Provider Programs. This role handles moderately complex to complex assignments that require in-depth analysis of situations, data, and variable factors.

The Senior Program Delivery Professional implements, monitors, and continuously improves program operational processes. This role evaluates existing business processes and develops sustainable, repeatable, and measurable improvements. Overseeing documentation, design, and implementation of both current and new processes for the Provider Programs operational area.

- Collects and analyzes data to develop and recommend business practices and procedures that improve the customer experience, support compliance, and increase efficiency. - Leads and oversees business process improvement initiatives, including cross-functional, end-to-end lifecycle documentation and improvement, such as product and performance lifecycles. - Supports, leads, and drives key organizational initiatives, including retrospective lessons learned and cross-functional collaboration opportunities. - Ensures process and procedure documentation is standardized and accurate across programs. - Develops, reviews, and approves program education/materials - Supports operating discipline, including rollout, adoption, and ongoing departmental review of enterprise support frameworks. - Supports Provider Programs financial management, including program administration, claims management, and departmental administrative expenses.

- 5+ years of experience in program delivery, operations, business process improvement, or related operational roles. - 2+ years of experience analyzing operational data and using findings to recommend process, compliance, customer experience, or efficiency improvements. - 2+ years of experience documenting, standardizing, or improving business processes across cross-functional teams or programs. - Experience using Microsoft Office tools, including Excel, PowerPoint, Outlook, and Teams, to manage reporting, documentation, communication, and stakeholder updates. - Experience with departmental finance activities and processes (budgeting, forecasting, invoicing, reconciliation, planning, etc..)

- Bachelor's degree in Business Administration, Health Care Administration, Operations, Finance, or a related field; master's degree preferred. - Experience applying Lean, Six Sigma, or other process improvement methodologies to improve operational efficiency, quality, or performance outcomes. - Experience supporting financial management activities, including budgeting, expense tracking, claims management, reporting, or program administration. - Experience in operational program management, business operations, or process execution within a matrixed or cross-functional environment. - Project Management Professional (PMP) certification or equivalent project/program management credential preferred. - Knowledge of health care, managed care, provider programs, risk adjustment, or clinical documentation workflows. - Strong analytical skills, including the ability to interpret data, identify trends, and translate insights into actionable business recommendations.