Vice President, Risk Adjustment

Morgan Consulting Resources, Inc. has been retained to conduct the search for the newly created position of Vice President, Risk Adjustment with Inland Empire Health Plan
. This highly visible leadership role will work on-site at IEHP’s Home Office, located at 10801 6th St., Rancho Cucamonga, CA with a remote schedule on Mondays and Fridays.

With a mission to heal and inspire the human spirit, Inland Empire Health Plan (IEHP) is one of the top 10 largest Medicaid health plans and the largest not‑for‑profit Medicare‑Medicaid plan in the country. In its 29th year, IEHP supports nearly 1.6 million members who are enrolled in Medicaid and has a growing network of over 8,000 providers and nearly 4,000 Team Members (Employees).

Through dynamic partnerships, award‑winning service, and a tradition of quality care, IEHP is fully committed to its Mission, Vision, and Values.

IEHP has consistently achieved outstanding employee engagement scores from its 4,000+ Team Members and was most recently recognized and awarded the designation of ‘Great Place to Work’ for a third year in a row! For details regarding IEHP, please visit iehp.org.

Reporting to the Chief Financial Officer (CFO), the Vice President of Risk Adjustment (VP) will define and lead the enterprise vision and strategy for risk adjustment across all IEHP product lines, ensuring alignment with the organization’s mission and long‑term financial sustainability. This senior leader will oversee risk adjustment programs that drive accurate risk scores, optimize revenue, and ensure regulatory compliance, while integrating risk adjustment into value‑based care initiatives.

In close partnership with finance, actuarial, quality, and clinical leaders, the VP will forecast revenue, manage financial risk, and enhance provider engagement through education, incentives, and value‑based programs. The role provides oversight of audits and program integrity, establishes key performance indicators, and champions innovation through analytics, optimization, and technical solutions. As a senior leader, the VP will build and mentor high‑performing teams, manage vendor and partner relationships, and anticipate regulatory changes related to risk adjustment programs to ensure organizational readiness.

The VP will evaluate current processes, identify gaps, and implement innovative solutions that improve coding accuracy and strengthen revenue capture. This role requires a visible, influential leader who can clearly communicate strategy and performance to executives, key stakeholders, providers, and regulatory bodies. The role is accountable for reporting performance results, providing strategic recommendations to executive leadership, and ensuring transparency, financial sustainability, and alignment with the organization’s mission.

• Define and execute the enterprise vision for risk adjustment across all product lines, aligning strategies with IEHP’s mission, business objectives, and long‑term financial sustainability.
• Provide strategic leadership and enterprise oversight of programs that deliver accurate risk scores and optimized revenue while ensuring full compliance with CMS, DHCS, and Covered California regulations.
• Embed risk adjustment into quality, performance, and value‑based care initiatives while partnering with Finance, Actuarial, Quality and Clinical leaders to forecast revenue and manage financial risk.
• Develop and implement impactful provider engagement strategies, including education, incentives, and value‑based initiatives that strengthen documentation accuracy and coding best practices.
• Provide executive oversight of internal and external audit functions and architect enterprise‑wide program integrity frameworks that ensure regulatory compliance, mitigate organizational risk, and safeguard revenue accuracy across all lines of business.
• Establish key performance indicators, dashboards, and reporting systems while advancing EMR optimization, analytics, and technology solutions that drive continuous improvement.
• Build, mentor, and lead high‑performing teams while providing strategic oversight of vendors and…