Medical Director, Risk Adjustment | Optum

Colorado Springs, CO

Key Info



Responsible for administration and oversight of the medical and clinical activities of employed and contracted providers as well as various operations functions within assigned market(s) to ensure appropriate practices related to risk adjustment activities, HEDIS measures, and any appropriate gaps in care. The Medical Director works collaboratively with all facets of the business and business leadership including Risk Adjustment, Clinical Education team, other Medical Directors and leaders, coding department, physicians, site administrators and operations, to educate and improve accurate coding and documentation skills, leading to a more complete patient record.

The Risk Adjustment Medical Director is responsible to lead efforts to improve risk adjustment programs including accurate documentation and coding and to be accountable for those improvements and outcomes. The Director acts as a resource for national and network leadership as well as physicians, specialists, and hospitalists.

The Risk Adjustment Medical Director is further responsible for keeping up to date on changes in the Medicare risk adjustment model or other documentation requirements.

Specific Job Skills and Experience:

  • Minimum 3 years of practicing medicine
  • Over 2 years of CMS-HCC operations experience
  • Over 3 years of supervisory experience.
  • Licensed physician in the state of Colorado, with knowledge of the coding/billing/documentation
  • Ability to engage contracted providers through indirect influence


  • Excellent range of knowledge with respect to the practice of medicine. Ability to speak clearly and communicate with agencies, other physicians and staff regarding patient care.


  • Ability to develop positive interaction with physicians, administrators and co-workers in order to effectively care for the patient.


MD or DO.


  • Current and Unrestricted license to practice medicine in the State of Colorado.
  • Current and Unrestricted DEA

Posted August 6, 2020


Not Covered