Director, Risk Adjustment

Director, Risk Adjustment Location: Remote/Hybrid (Strongly Preferred: Chicago, IL) Reports to: Vice President, Provider Strategy & Population Health Company: Town Square Health About Town Square Health Town Square Health is reimagining what healthcare can be. We’re building a first-of-its-kind value-based care model with a singular mission: to set the gold standard for how Americans experience healthcare. We offer comprehensive primary care with coordinated specialty support for Medicare-eligible patients, and we’re growing fast, with expansion into multiple markets on the horizon. If you’re bold, collaborative, and driven to make a real difference in people’s lives, we’d love to have you on our team! The Opportunity This is not a traditional risk adjustment role. Town Square Health is seeking a Director, Risk Adjustment to own our end-to-end approach to accurate, timely risk capture across our Medicare patient population. At its core, this role is about one thing: building a function that works–one that connects clinical documentation, coding operations, and technology into a coherent, scalable system that serves both patients and the organization. We’re not looking for someone who has mastered every corner of this space in isolation. We’re looking for a leader who understands how the pieces connect, can set a clear direction, bring the right people and tools together, and build something that lasts. You’ll have strong partners in clinical, technology, and population health–your job is to align them and drive. You’ll have the opportunity to: Define and own Town Square Health’s risk adjustment strategy from the ground up Build and lead a team, shaping how we hire, develop, and retain coding and RCM talent Influence how we adopt technology, including AI-enabled tools, to make documentation faster and more accurate Work cross-functionally at a high level of visibility, partnering with clinical, operations, and technology leadership Help establish accurate and specific risk adjustment as we scale into new markets What You’ll Do You’ll lead the risk adjustment function end to end, setting strategy, building team capability, and ensuring the operational pieces work together. Below is a view into the key areas you’ll own. You don’t need deep expertise in every one on day one; what matters is that you can lead across them, learn quickly, and build toward a high-performing whole. Strategy & Roadmap Partner with the VP, Provider Strategy & Population Health to define our risk documentation strategy and prioritize the highest-impact initiatives Design a roadmap for accurate, timely documentation in a value based care space Identify opportunities to simplify and automate workflows, with an eye toward tools and technology that scale Keep clinical, technology, and operations aligned and accountable- turning strategy into clear plans with owners and timelines Team Leadership & Development Build, lead, and develop a team of Risk Coders, Revenue Cycle Coders, and RCM Specialists Design onboarding, training, and education programs that set your team up for consistent, high-quality performance Foster a culture of accountability, continuous improvement, and collaboration within the team Monitor key performance metrics and use data to identify coaching opportunities and process improvements Technology & Vendor Partnership Assess build-vs-buy options for documentation and coding tools in partnership with the VP, Provider Strategy & Population Health and Chief Technology Officer Lead vendor evaluations - scoping requirements, assessing ROI, and synthesizing recommendations for leadership Partner with Technology and Operations on implementation, integration, and workflow design for new tools Clinical & Revenue Cycle Alignment Collaborate with the Medical Director of Population Health to design documentation workflows that are provider-friendly and clinically sound Serve as a subject matter resource on Revenue Cycle to ensure alignment between documentation, coding, and billing processes Support a culture of documentation excellence across the care team Who You Are You’re a leader who knows how to build. You’re comfortable with ambiguity, energized by complexity, and skilled at bringing clarity and direction to situations that don’t yet have either. You don’t need every answer on day one - but you know how to ask the right questions, find the right people, and keep things moving. You bring enough fluency across risk adjustment, coding operations, and revenue cycle to lead credibly - and enough intellectual curiosity to go deep where the work requires it. You’re as comfortable in a strategic planning conversation as you are reviewing coder productivity metrics or sitting in a vendor demo. Most importantly, you believe healthcare can be better, and you want to be part of the team proving it. Required Qualifications 5+ years of experience in value-based care, with meaningful exposure to HCC/risk adjustment documentation Experience leading or contributing to documentation strategy in a Medicare or managed care environment Familiarity with the intersection of clinical documentation, coding operations, and revenue cycle (you don’t need to be an expert in all three, but you need to understand how they connect) Strong analytical and communication skills; able to synthesize complex information and present clear recommendations to senior leadership Experience managing or developing a team, with a track record of building trust and driving performance Comfortable working cross-functionally and navigating ambiguity in an early-stage environment Exposure to technology evaluation or implementation in a healthcare setting is a plus, not a requirement Mission-driven mindset and a genuine passion for improving care for older adults What We Offer Starting salary range of $135,000–$150,000, based on experience Competitive performance-based incentives Comprehensive benefits package (medical, dental, vision, 401K) Flexible remote or hybrid work model, with preference for candidates who can work in-person 1–2 days per week in our Chicago, IL location Opportunity to build something from the ground up Direct impact on patient care and organizational outcomes High visibility and influence in a growing organization Collaborative, mission-driven team Equal Opportunity Employer Town Square Health is proud to be an equal opportunity employer. We believe that diverse perspectives and backgrounds make our team stronger and our mission more powerful. We welcome and encourage applications from all qualified individuals regardless of race, color, religion, sex, national origin, age, disability, veteran status, or any other legally protected characteristic. At Town Square Health, everyone belongs.