- Company: Montage Health
- Location: US
- Full Time
- US
- Apply on company site
Montage Health at a glance
montagehealth.org232 employees covered under a retirement plan (2024 filing) — via DOL Form 5500 / EFAST2
Montage Health (montagehealth.org) is a U.S. health system active on the Monterey Peninsula. Recent coverage includes partnering with Cal State Monterey Bay and donating funds to expand nursing education, buying Carmel Rancho Shopping Center with plans for a medical campus, and community support for older adults.
Join Montage Health as a Medicare Quality & Risk Adjustment Program Lead, a full-time healthcare leadership position based in the United States. This role combines clinical expertise with program management, overseeing Medicare Advantage quality initiatives, regulatory compliance, and data integrity to drive organizational performance.
About the Role
As the Medicare Quality & Risk Adjustment Program Lead at Montage Health, you'll direct critical healthcare quality programs that impact organizational outcomes and patient care. Working within our quality and compliance framework, you'll champion HEDIS measurement, Stars performance initiatives, risk adjustment accuracy, and audit readiness—ensuring Montage Health meets or exceeds Medicare Advantage program standards.
What You'll Do
- Lead Medicare Advantage quality program operations, serving as the primary clinical and technical expert for HEDIS reporting, data validation, and supplemental submission strategies
- Manage risk adjustment program activities, ensuring accurate member coding, diagnosis documentation, and regulatory alignment
- Oversee Stars rating performance initiatives and develop action plans to improve quality metrics across the organization
- Coordinate internal audit readiness processes, resolve compliance gaps, and prepare for external Medicare reviews
- Collaborate cross-functionally with clinical, coding, and operations teams to embed quality standards into daily workflows
- Monitor industry updates and regulatory guidance affecting Medicare Advantage programs and inform organizational strategy
What We're Looking For
- Registered Nurse (RN) with clinical background and demonstrated expertise in Medicare Advantage programs
- Strong knowledge of HEDIS measures, quality reporting, or risk adjustment operations
- Proven program management and cross-functional leadership experience
- Detail-oriented approach with excellent analytical and organizational skills
- Ability to communicate complex healthcare and regulatory concepts to diverse teams
- Working knowledge of healthcare compliance, audit processes, and CMS requirements
About Montage Health
Montage Health is dedicated to advancing quality care and clinical excellence for the communities we serve across the United States.
How to Apply
To apply, complete your application directly on this page, or you'll be redirected to the employer's application platform to finish submitting there.
Apply now
Takes about a minute — like Indeed Apply. The employer sees you in their Candidates list.
To apply for this job please visit www.adzuna.com.
Explore Montage Health online
What people say about Montage Health
- Ask HN: Who is hiring? (April 2013)
- Ask HN: Who Is Hiring? (August 2012)
- Paul Graham Thinks You Should Exercise
- UAE to leave OPEC
Recent news
- Cal State Monterey Bay partners with Montage Health to expand nursing education - California State University Monterey Bay
- Montage Health buys Carmel Rancho Shopping Center with plans to build a medical campus. - Monterey County Weekly
- In support of the elderly - Monterey Herald
- Montage Health donates $15 million to expand nursing education at CSUMB - KSBW
- Guest Column | Transforming Healthcare Together: Cal State Monterey Bay and Montage Health Forge a Powerful Partnership - The King City Rustler
Aggregated from public discussions and news; opinions are the authors’ own.
Working in US
The listing location is the United States (not remote). No city-level housing, transit, or neighborhood detail is in the data—only national scope.
🇺🇸 Relocation safety for US: Exercise Normal Caution — via Warnely, CC BY 4.0
National unemployment rate in US: 4.2% — via World Bank
National job openings rate: 4.6% — via BLS JOLTS
Private-sector wage growth (year over year): 3.3% — via FRED
National quits rate: 1.9% — via FRED (BLS JOLTS)
Weekly initial unemployment claims: 215,000 — via FRED
GDP per capita in US: $90,027 — via World Bank
Consumer price inflation in US: 2.9% (annual) — via World Bank
Real GDP growth in US: 2.2% (annual) — via World Bank
Average hours worked per year in US: 1,800 — via OECD
Build the skills for this role
Prioritize Medicare quality programs (e.g., Stars-related measures), HCC/risk adjustment literacy, and healthcare data fluency. Useful practice includes chart-review workflows, provider education, and audit-ready documentation. No certification list or costs were provided in the source data.
Be ready to walk through a Medicare quality or risk-adjustment initiative you led: baseline, interventions, stakeholders, and outcomes. Expect scenarios on incomplete documentation, measure underperformance, and coordinating Aspire Health–style programs inside a health system.
Strong fit if you have Medicare quality or risk-adjustment program experience and can lead without day-to-day clinical practice. Less fit if you want pure bedside nursing or software-only work with no regulatory quality context.
Job details above are provided by the employer/source. The sections on this page are compiled from public data sources with AI assistance.
Accommodations: if you need a workplace accommodation to apply for or perform this job, see ADA.gov or EEOC.gov for guidance on your rights and how to request one.
Listing facts
- Role Medicare Quality & Risk Adjustment Program Lead – Aspire Health
- Employer Montage Health
- Location US
- Type Full Time
- Posted July 3, 2026
- Apply by 2026-08-08
- Country context US
- Overview Full original description on this page (313 words; rewritten for clarity, not a teaser paste)
Facts above come from this job record on Get A Job.AI — not copied from third-party review sites.
Public discussions & open sources
Attributed public threads and profiles — not employee reviews or star ratings.
- Hacker News — Ask HN: Who is hiring? (April 2013)
- Hacker News — Ask HN: Who Is Hiring? (August 2012)
- Hacker News — Paul Graham Thinks You Should Exercise
- Hacker News — UAE to leave OPEC
Cached public sources (Hacker News, Dev.to, GitHub, etc.).
Employer website
Explore related openings
1 other opening(s) at Montage Health on Get A Job.AI
Research this employer
Pull public facts we already cached for this company (Wikipedia, news, discussions). We never invent Glassdoor-style ratings.
Open interview kit (print-friendly)
Get email alerts for similar jobs
Keep exploring on Get A Job.ai
Not quite the right fit? Your next opportunity is a click away.
- Browse all jobs
- More jobs by category
- Remote jobs you can do from anywhere
- Research typical pay for this role
- Set a job alert so new matches reach you first
- Upload your resume to apply faster
- Register now to access our free AI resume builder
Hiring instead? Post a job and reach candidates searching right now.