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Job description
Location Detail: 100 Pearl Street Hartford (10484)
Medical Director, Risk Adjustment | Hartford HealthCare
Hartford, Connecticut
Hartford HealthCare is seeking a Board Certified Physician to join our Clinical Integration team. The Medical Director, Risk Adjustment is a practicing physician who provides clinical leadership and oversight for the organization's risk adjustment, clinical documentation integrity, and clinician education initiatives. This role partners closely with Quality, Clinical Integration, Population Health, Revenue Cycle, Health Economics, and Operational leadership to ensure accurate and compliant documentation of patient complexity, severity of illness, and chronic disease burden across value-based care programs.
The Medical Director serves as the physician champion for risk adjustment, promoting evidence-based documentation practices, supporting clinician engagement, and ensuring the accurate representation of patient populations in Medicare Advantage, MSSP, Commercial Value-Based Contracts, and other risk-adjusted payment models.
Position Highlights
Strategic Leadership
Provide physician leadership for all risk adjustment and documentation improvement initiatives.
Develop and support organizational strategies to improve risk score accuracy, condition recapture rates, documentation quality, and compliance.
Participate in the development of annual risk adjustment goals, metrics, and performance improvement plans.
Advise leadership on regulatory changes, CMS guidelines, and industry best practices impacting risk adjustment programs.
Support value-based care initiatives by ensuring accurate representation of patient complexity and clinical burden.
Physician Engagement & Education
Serve as the physician champion for risk adjustment and documentation excellence.
Lead clinician-facing education regarding HCC coding, documentation requirements, chronic disease management, and risk-adjusted payment methodologies.
Present practice-level performance data and opportunities for improvement to physicians and leadership teams.
Partner with Clinician Integration Managers and Risk Adjustment Educators to develop educational content and communication strategies.
Facilitate discussions with physicians regarding coding opportunities, documentation clarification, and workflow optimization.
Clinical Documentation & Coding Oversight
Provide clinical oversight and guidance on documentation integrity initiatives.
Review documentation and coding trends to identify opportunities for improvement.
Assist in the resolution of complex clinical validation and documentation questions.
Support development of compliant documentation standards consistent with CMS regulations and organizational policies.
Collaborate with coding and CDI professionals to ensure documentation accurately reflects patient complexity and care delivery.
Quality, Analytics & Performance Improvement
Review risk adjustment performance metrics, RAF trends, prevalence reports, suspect condition capture rates, and clinician-level performance dashboards.
Assist with identification of high-impact improvement opportunities.
Partner with Health Economics and Analytics teams to interpret clinical performance data.
Support audits, data validation, and quality assurance activities.
Compliance & Regulatory Oversight
Promote compliance with CMS, Medicare Advantage, MSSP, and payer-specific documentation requirements.
Support internal and external audit activities.
Ensure educational and documentation initiatives align with regulatory standards and organizational policies.
Participate in monitoring activities to identify and mitigate compliance risks.
Comprehensive Benefits
Generous paid time off + company holidays
CME allowance + dedicated CME time
Reimbursement for licenses, certifications, and professional dues
401(k) with strong employer match
Family-focused benefits including backup childcare support
Voluntary benefits: tuition programs, insurance options (home, auto, pet), legal services, identity protection, and more
Why Hartford HealthCare?
Hartford HealthCare is a not-for-profit, fully integrated healthcare system with a strong reputation for clinical excellence, innovation, and physician leadership.
8 acute care hospitals and a large multi-specialty network
Statewide presence with access to specialists and referrals
Physician-led culture focused on quality, collaboration, and growth
Recognition & Awards
"A" Leapfrog Safety Rating (one of few systems nationwide)
"Best Organizations for Leadership Development" - National Center for Healthcare Leadership
"Best Hospitals to Work For in Connecticut" - Becker's Hospital Review
"America's Most Innovative Companies" - Fortune
"Best Regional Hospitals" - U.S. News & World Report
Professional Growth & Development
Hartford HealthCare is committed to physician development through:
Provider Leadership Development Institute
The Center for Education, Simulation & Innovation (CESI)
Robust CME and on-demand learning platforms
Mentorship and career advancement opportunities
Live & Work in Hartford, Connecticut
Hartford County offers a high quality of life with easy access to Boston, New York City, and Providence:
Family-friendly communities with excellent schools
Coastal living, outdoor recreation, and scenic New England charm
Short commutes and a balanced lifestyle
Qualifications
Current unrestricted Connecticut medical license
Board certification in a recognized specialty
Active clinical practice maintained throughout employment
Minimum 5 years of clinical practice experience
Experience in population health, quality improvement, or value-based care initiatives
Demonstrated leadership experience with physicians or multidisciplinary teams
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Worksite address
hartford, CT, 06112, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.