Risk Adjustment and Quality Reporting Manager

Why Join CINQCARE?

CINQCARE is a provider-led, community-based health and care partner dedicated to improving the health and well-being of those who need care the most, with a deep commitment to high-needs, urban and rural communities. Our local physicians, nurses, and caregivers work together to serve people and the communities they live in, beyond just treating symptoms. We remove barriers by delivering personalized care as close to home as possible, often in-home, because we know a deep understanding of our patient’s race, culture, and environment is critical to delivering improved health outcomes. By empowering patients, providers, and caregivers with the support they need, we strive to make health and care a reality—not a burden—every single day. Join us in creating a better way to care.

Position Overview

The Risk Adjustment & Quality Reporting Manager reports to the VP Quality & Risk Adjustment with accountability for providing strategy, judgment, organization, and evidenced-based analysis to influence decisions, and directly to meet CINQCARE requirements. They should embody CINQCARE’s core values, including, Trusted, Empathetic, Committed, Humble, Creative and Community-Minded. At CINQCARE, we don’t have patients or customers – we have Family Members

Key Responsibilities

The Risk Adjustment & Quality Reporting Manager will have the following responsibilities:

• Lead the implementation and ongoing management of risk adjustment strategies to ensure accurate risk scores and optimal reimbursement.
• Monitor and analyze the effectiveness of risk adjustment initiatives and adjust strategies to improve performance.
• Collaborate with clinical teams to identify high-risk patients and ensure that all relevant diagnoses are appropriately captured and documented.
• Analyze data to identify trends, gaps, and opportunities in risk adjustment and quality performance.
• Prepare and present regular reports to senior leadership, detailing performance on risk adjustment, quality reporting, and regulatory compliance.
• Use data to inform decision-making and drive initiatives for improvement in risk adjustment and quality outcomes.

Required Qualifications

• Bachelor’s degree or equivalent degree with a record of strong academic achievement.
• At least 5 years of quality & risk experience. Ideal candidates will have 5+ years of relevant quality & risk experience in the healthcare industry.
• Excellent verbal, written communication and presentation skills; ability to clearly articulate and present concepts and models in an accessible manner to CINQ’s team, investors, partners and other stakeholders.
• Proficiency in all Microsoft Office applications.
• Ability to build and effectively manage relationships with business leaders and external constituents.
• Good judgement, impeccable ethics, and a strong team player; desire to succeed and grow in a fast-paced, demanding and entrepreneurial Company.

Our Benefits

At CINQCARE, we care for our team like we care for our patients—holistically. We offer flexible, comprehensive benefits so you can thrive while delivering top-notch care.

• Medical Plans: Two comprehensive options offered to Team members.
• 401K: 4% employer match for your future.
• Dental & Vision: Flexible plans with in-network savings.
• Paid Time Off: Generous PTO, holidays, and wellness time.
• Extras: Pet insurance, commuter benefits, mileage reimbursement, CME for providers, and company-provided phones for field staff.

The working environment and physical requirements of the job include:

Work is performed indoors in a setting with conditioned air and artificial light. Travel to and work in offices or other environments is required.

In this position you will need an to communicate with customers, vendors, management, and other co-workers in person and over devices, sometimes with people who are agitated. Regular use of the telephone and e-mail for communication is essential. Sitting for extended periods is common. Must be able to receive ordinary information and to prepare or inspect documents. Lifting of up to 10 lbs. occasionally may be required. Good manual dexterity for the use of common office equipment such as computer terminals, calculator, copiers, and FAX machines. Good reasoning ability is important. Able to understand and utilize management reports, memos, and other documents to conduct business.

Equal Opportunity & Reasonable Accommodation Statement

CINQCARE is an Equal Opportunity Employer committed to creating an inclusive environment for all employees. We provide equal employment opportunities to all individuals regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic under applicable law.

If you require a reasonable accommodation during the application or employment process, please indicate this in your application or speak with your recruiter during the hiring process.

Disclaimer

This job description is intended to describe the general nature and level of work being performed. It is not intended to be an exhaustive list of all responsibilities, duties, and skills required. Management reserves the right to modify, add, or remove duties as necessary.