{"id":1196616,"url":"https://alion.io/job/mosaic-health-manager-burden-of-illness-operations-rbe","title":"Manager, Burden of Illness Operations (RBE)","company":{"id":2681556,"name":"Mosaic Health","domain":"mosaichealth.com","url":"https://alion.io/company/mosaic-health","size_band":"1001-5000","is_staffing_agency":false,"is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":null},"role":"Industrial Engineering","role_family":"Industrial Engineering","seniority":"senior","employment_type":"full_time","work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Fort Myers, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":85159,"max":127738,"currency":"USD","period":"year","gross":null,"usd_annual":127738},"salary_estimate":null,"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Office","optional":false}],"status":"live","first_seen_at":"2026-08-06T00:00:00Z","employer_posted_date":"2026-08-06","last_verified_at":"2026-09-25T03:35:54Z","board_verified":true,"closed_at":null,"days_open":50,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":50},"description":"Job Description Summary\n\nThe Manager of Burden of Illness (BOI) reports to the Director of Burden of Illness. The Manager is responsible for the day-to-day management and execution of the organization's Burden of Illness and Risk Adjustment initiatives. This role oversees operational workflows, leads the BOI team, monitors performance metrics, and collaborates with internal departments and external partners to improve coding accuracy, documentation quality, and risk adjustment performance. The Manager supports organizational value-based care initiatives by ensuring operational excellence, regulatory compliance, and continuous process improvement.Essential Duties and Responsibilities\nManage daily BOI and Risk Adjustment operations to ensure timely and accurate execution of departmental goals.\nSupervise, mentor, and develop BOI team members while fostering a culture of accountability, collaboration, and continuous improvement.\nMonitor key performance indicators (KPIs), coding trends, provider performance, RAF accuracy, and documentation quality.\nAnalyze operational and financial data to identify opportunities for workflow improvements and increased coding capture.\nEnsure compliance with CMS, Medicare Advantage, ACO, and other regulatory coding and documentation requirements.\nCollaborate with Clinical Operations, Provider Relations, Quality, Finance, IT, Analytics, and Population Health teams to support organizational objectives.\nPartner with vendors and health plan representatives to support operational performance and contractual deliverables.\nOversee reporting related to code validation, provider performance, prevalence rates, RAF trends, acceptance/rejection rates, and quality metrics.\nIdentify opportunities to improve technology, reporting, automation, and operational efficiency.\nDevelop and implement standardized workflows, policies, and best practices.\nSupport provider education initiatives focused on documentation improvement and coding accuracy.\nMonitor coding quality through audits and provide feedback to coding staff and leadership.\nPrepare and present operational reports and recommendations to department leadership.\nParticipate in strategic initiatives and special projects supporting value-based care and population health programs.\nAssist leadership with annual operational planning, staffing, budgeting, and resource allocation.\n• Maintain effective communication with internal stakeholders and external partners.\n\nHow will you make an impact & Requirements\n\nThe Manager of Burden of Illness (BOI) reports to the Director of Burden of Illness. The Manager is responsible for the day-to-day management and execution of the organization's Burden of Illness and Risk Adjustment initiatives. This role oversees operational workflows, leads the BOI team, monitors performance metrics, and collaborates with internal departments and external partners to improve coding accuracy, documentation quality, and risk adjustment performance. The Manager supports organizational value-based care initiatives by ensuring operational excellence, regulatory compliance, and continuous process improvement.\nEssential Duties and Responsibilities\nManage daily BOI and Risk Adjustment operations to ensure timely and accurate execution of departmental goals.\nSupervise, mentor, and develop BOI team members while fostering a culture of accountability, collaboration, and continuous improvement.\nMonitor key performance indicators (KPIs), coding trends, provider performance, RAF accuracy, and documentation quality.\nAnalyze operational and financial data to identify opportunities for workflow improvements and increased coding capture.\nEnsure compliance with CMS, Medicare Advantage, ACO, and other regulatory coding and documentation requirements.\nCollaborate with Clinical Operations, Provider Relations, Quality, Finance, IT, Analytics, and Population Health teams to support organizational objectives.\nPartner with vendors and health plan representatives to support operational performance and contractual deliverables.\nOversee reporting related to code validation, provider performance, prevalence rates, RAF trends, acceptance/rejection rates, and quality metrics.\nIdentify opportunities to improve technology, reporting, automation, and operational efficiency.\nDevelop and implement standardized workflows, policies, and best practices.\nSupport provider education initiatives focused on documentation improvement and coding accuracy.\nMonitor coding quality through audits and provide feedback to coding staff and leadership.\nPrepare and present operational reports and recommendations to department leadership.\nParticipate in strategic initiatives and special projects supporting value-based care and population health programs.\nAssist leadership with annual operational planning, staffing, budgeting, and resource allocation.\nMaintain effective communication with internal stakeholders and external partners.\nEducation and Experience\nBachelor's degree in Healthcare Administration, Business Administration, Public Health, or related field or equivalent years of experience.\nMinimum 5 years of Medicare Risk Adjustment experience.\nMinimum 2-3 years of leadership or supervisory experience.\nExperience with Medicare Advantage, MSSP ACOs, and value-based care programs preferred.\nStrong knowledge of CMS-HCC Risk Adjustment methodology.\nRequired Skills and Abilities\nStrong leadership and team development skills.\nExcellent analytical and problem-solving abilities.\nKnowledge of Risk Adjustment operations and coding compliance.\nStrong communication and presentation skills.\nAbility to prioritize multiple projects in a fast-paced environment.\nExperience leading operational improvement initiatives.\nStrong collaboration and relationship-building skills.\nAbility to communicate complex data into actionable recommendations.\nHigh attention to detail and organizational skills.\nProficiency with Microsoft Office and reporting tools.\nManagerial Responsibilities\nDirectly supervise BOI team members and coding staff.\nConduct hiring, onboarding, coaching, performance evaluations, and corrective action when appropriate.\nEstablish team goals aligned with departmental objectives.\nMonitor productivity, quality metrics, and staff development.\nPromote employee engagement and professional growth.\nFoster collaboration across departments.\nKey Performance Measures\nBOI capture rate improvement\nRAF accuracy\nCoding quality scores\nProvider engagement and education completion\nCoding turnaround times\nAudit accuracy\nVendor performance\nDepartment productivity\nCompliance with CMS and organizational standards\nTeam engagement and retention\n\nCompensation Range:\n$85,159.00to\n$127,738.00The anticipated base salary range represents the Company's good-faith estimate of the compensation it reasonably expects to pay for this position at the time of posting. Actual compensation will be determined based on factors including experience, skills, qualifications, geographic location, internal equity, and business needs.","description_format":"text","description_chars":7035,"description_truncated":false,"requirements":{"experience_years_min":5,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"bachelor","optional":false},"security_clearance":false,"languages":[]},"benefits":["Equity"],"hiring_locations":[],"hiring_excludes":[],"relocation_offered":false,"industries":[],"lifecycle":[{"event":"open","at":"2026-09-24T18:49:38Z"}],"liveness":{"score":26,"band":"fade","label":"Fading","p_open":1,"p_active":0.584,"p_room":0.45,"age_days":50,"expected_fill_days":31,"reasons":["conf:0","win:tail"],"computed_at":"2026-09-25T03:51:47Z"},"pay":{"stated_usd_annual":127738,"is_top_pay":false},"html_url":"https://alion.io/job/mosaic-health-manager-burden-of-illness-operations-rbe","json_url":"https://alion.io/job/mosaic-health-manager-burden-of-illness-operations-rbe.json","meta":{"generated_at":"2026-09-25T03:51:47Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","usage":{"tier":"crawler","counted_by":"address","units_charged":1,"used_today":4213,"day_limit":5000,"remaining_today":787,"minute_limit":60,"resets_at":"2026-09-26T00:00:00Z"}}}