About the job
Interwell Health is a leading kidney care management organization dedicated to transforming healthcare. We partner with physicians to deliver innovative solutions that enhance patient care and improve outcomes. Our mission is rooted in compassion, expertise, and a commitment to excellence, ensuring that our patients can live their healthiest lives. If you share our vision of reimagining healthcare, we invite you to join our team!
Key Responsibilities
The Director of Risk Adjustment will play a pivotal role as a strategic operational leader, enhancing risk adjustment performance across our payer and government programs. This position entails advancing Interwell's risk adjustment capabilities while ensuring compliance within a highly regulated environment. You will be responsible for translating organizational strategies into effective, scalable programs and collaborating with cross-functional teams in clinical, coding, analytics, and provider engagement.
In this capacity, you will drive daily operations, implement new pilot initiatives, and optimize existing programs. Your expertise will be vital in identifying opportunities for performance enhancement, formulating strategies for implementation, and overseeing the execution of performance-related initiatives for Nephrology providers.
Essential Functions:
Enterprise Strategy & Organizational Leadership
- Lead the formulation and execution of a comprehensive risk adjustment strategy that aligns with clinical, operational, and financial priorities.
- Transform organizational goals (e.g., RAF improvement, recapture performance, coding accuracy) into actionable, scalable initiatives.
- Collaborate with executive leadership to harmonize risk adjustment objectives across Medicare Advantage, CKCC, and commercial populations.
- Foster innovation and drive continuous improvement through advanced analytics, AI/NLP, and point-of-care solutions.
Three-Pronged Risk Adjustment Approach
This role encompasses the design and implementation of a holistic risk adjustment strategy anchored in three fundamental pillars:
- Patient-Level Tracking: Establish and operationalize comprehensive tracking of all suspected and recaptured conditions at the patient level, facilitating proactive management of coding gaps.

