Vice President, Risk

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 Vice President of Risk serves as the executive leader responsible for CINQCARE’s enterprise-wide risk adjustment strategy, documentation integrity, and compliance operations. This leader will ensure accurate risk capture, a strong partnership with medical practices, and alignment with CINQCARE’s value-based care goals.

The VP will partner closely with Clinical, Practice Transformation, Provider Network, Quality, Population Health, Finance, and Market leadership to design and deliver proactive risk strategies that enable accurate coding, optimized reimbursement, and improved outcomes for our Family Members.

Key Responsibilities

Strategic & Operational Leadership

• Lead the design, execution, and continuous improvement of CINQCARE’s risk adjustment strategy to ensure accurate risk scores, compliant documentation, and optimal reimbursement.
• Manage the end-to-end process for accurate and timely documentation and coding of diagnoses and medical procedures in compliance with ICD-10, CPT, HCPCS, CMS, and payer guidelines.
• Stay current with regulatory changes, payer policies, CMS methodologies, and industry trends to ensure compliance and maximize revenue opportunities.
• Use data-driven insights to shape enterprise strategy, inform decisions, and drive performance improvements in documentation quality, risk accuracy, and reimbursement.

Practice Partner Support

• Lead the team responsible for assisting and supporting CINQCARE’s medical practice partners across markets.
• Set performance expectations with medical practices based on contractual obligations and ensure accountability for documentation quality, risk score improvement, and workflow changes.
• Provide clear and consistent communication, training, and coaching to practice leaders and staff to enhance documentation and coding accuracy.
• Support practice teams in building durable workflows that align with CINQCARE’s standards and organizational values.

Performance Improvement & Analytics

• Drive strategy around improvement opportunities through root cause analysis, action plans, and collaborative problem-solving with medical practice and clinical leadership.
• Monitor, track, and analyze key performance indicators (KPIs) related to documentation completeness, coding accuracy, encounter submission timeliness, and risk score performance.
• Analyze trends, identify gaps, and lead initiatives that strengthen CINQCARE’s performance in risk adjustment and related quality outcomes.
• Prepare and present high-level reports, insights, and recommendations to senior leadership and cross-functional partners.

Quality, Risk & Population Health Integration

• Collaborate with clinical teams to identify high-risk patients and ensure all relevant diagnoses are accurately captured and documented.
• Collaborate with Population Health, Quality, and Clinical Operations to align documentation accuracy with broader clinical and care management initiatives.
• Support risk and quality improvement efforts by assessing current-state workflows and creating integrated solutions that enhance performance across markets.
• Ensure risk adjustment work is connected to preventive care gaps, chronic condition management, and overall member experience.

Documentation, Coding & Compliance Leadership

• Ensure that all relevant diagnoses are accurately captured, documented, and submitted in accordance with CMS and payer requirements.
• Leads collaboration with payers and CMS to align organizational quality initiatives with federal and payer-driven performance programs, ensuring continuous improvement and compliance with value-based care standards.
• Oversee coding quality programs, retrospective and prospective reviews, and internal audits.
• Develop and maintain strong internal controls that minimize compliance risk and strengthen documentation integrity.

Training & Education

• Support the development and delivery of internal training programs for CINQCARE staff and medical practices focused on documentation accuracy, risk adjustment requirements, and compliant coding practices.
• Reinforce strong communication practices and time management skills that reflect CINQCARE’s core values: Trusted, Empathetic, Committed, Humble, Creative, and Community-Minded.

Required Qualifications

• Education: Bachelor’s degree required; advanced degree (MPH, MBA, MHA, or related) strongly preferred.
• Experience:
  • 10+ years of progressive experience in risk adjustment, population health, or value-based care.
  • 5+ years in a senior leadership role within a healthcare organization (payer, provider, ACO, or value-based entity).
  • Extensive experience with CMS HCC models, coding programs, VBC contracts, and regulatory frameworks.
  • Deep expertise in HCC coding, documentation improvement, and risk regulatory requirements.
  • Strong analytical and financial acumen, with the ability to interpret complex data.
  • Exceptional communication and executive presentation skills.
  • Proficiency with Microsoft Office and familiarity with analytics platforms.

The working environment and physical requirements of the job include:

In-office work is performed indoors in a traditional office setting with conditioned air, artificial light, and an open workspace.

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.

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.

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.