Application Guide

How to Apply for Risk Adjustment Director

at Ccah

🏢 About Ccah

Central California Alliance for Health (CCAH) is a community-based Medi-Cal managed care plan committed to accessible, quality healthcare guided by local innovation. They prioritize human-centered hiring, reviewing every application manually, and value candidates connected to the communities they serve in Santa Cruz, Monterey, Merced, San Benito, and Mariposa counties.

About This Role

As Risk Adjustment Director, you will lead the Risk Adjustment Department, reporting to the CFO, and oversee the design, implementation, and management of risk adjustment strategies to ensure accurate capitation payments and quality outcomes. This role is impactful because it directly influences the financial sustainability and quality of care for underserved populations in Central California.

💡 A Day in the Life

You'll start your day reviewing risk adjustment data reports and dashboards, then lead a team meeting to discuss ongoing projects like chart reviews or vendor performance. Afternoons might involve a cross-functional call with finance and quality teams to align on risk adjustment initiatives, followed by strategic planning for upcoming regulatory changes. Once a quarter, you'll travel to the service area for in-person collaboration with local teams and community partners.

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🎯 Who Ccah Is Looking For

  • Proven experience in risk adjustment leadership within a managed care plan or health insurance setting, with deep knowledge of CMS-HCC and Medi-Cal risk adjustment models.
  • Strong strategic and analytical skills, with a track record of designing and implementing risk adjustment programs that improve accuracy and compliance.
  • Excellent leadership and communication abilities, capable of managing a department and collaborating with cross-functional teams like finance, quality, and clinical operations.
  • Familiarity with California's Medi-Cal landscape and a commitment to serving diverse, rural, and underserved communities is highly valued.

📝 Tips for Applying to Ccah

1

Emphasize your experience with risk adjustment in a Medi-Cal or managed care setting, as this is a Medi-Cal plan with specific regulatory nuances.

2

Tailor your resume to highlight leadership in designing risk adjustment programs, including any improvements in RAF scores or payment accuracy.

3

Mention your connection to or willingness to relocate to the service counties (Santa Cruz, Monterey, Merced, San Benito, Mariposa) or California residency, as priority is given to local candidates.

4

In your cover letter, explicitly reference the company's mission of 'accessible, quality health care guided by local innovation' and how your work aligns.

5

Avoid generic AI-generated content; the company explicitly states they do not use AI to review applications, so ensure your application feels authentic and human-written.

✉️ What to Emphasize in Your Cover Letter

["Your passion for serving underserved communities and how your risk adjustment expertise can support CCAH's mission of local innovation.", 'Specific examples of strategic risk adjustment initiatives you led that improved payment accuracy or quality outcomes.', 'Your leadership style and experience managing teams in a remote or hybrid environment, as this role is remote with quarterly travel.', "Your understanding of California's Medi-Cal environment and any experience with DSRIP or other state-specific programs."]

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🔍 Research Before Applying

To stand out, make sure you've researched:

  • → Review CCAH's website to understand their mission, service area, and recent news or initiatives related to risk adjustment or quality improvement.
  • → Look into California's Medi-Cal risk adjustment model and any recent policy changes (e.g., managed care organization tax, quality incentive programs).
  • → Research the demographics and health challenges of the five service counties to demonstrate cultural competency and local focus.
  • → Check the LinkedIn profiles of the CFO (reporting line) and current Risk Adjustment team to understand the team structure and priorities.

💬 Prepare for These Interview Topics

Based on this role, you may be asked about:

1 How would you design a risk adjustment strategy to improve RAF scores while ensuring compliance and data integrity?
2 Describe a time you led a cross-functional initiative involving finance, clinical, and quality teams to address a risk adjustment challenge.
3 How do you stay current with regulatory changes in risk adjustment, especially in Medi-Cal?
4 This role reports to the CFO – how would you communicate risk adjustment insights to a non-clinical executive audience?
5 What is your experience with risk adjustment data analytics tools and vendor management?
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⚠️ Common Mistakes to Avoid

  • Submitting a generic application that doesn't reference CCAH's mission or service area – they value local connection and personalized applications.
  • Overlooking the requirement to reside in California upon hire – ensure your resume and cover letter address this clearly.
  • Focusing only on technical risk adjustment skills without demonstrating leadership, strategic thinking, or community orientation.

📅 Application Timeline

This position is open until filled. However, we recommend applying as soon as possible as roles at mission-driven organizations tend to fill quickly.

Typical hiring timeline:

1

Application Review

1-2 weeks

2

Initial Screening

Phone call or written assessment

3

Interviews

1-2 rounds, usually virtual

✓

Offer

Congratulations!

Ready to Apply?

Good luck with your application to Ccah!

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