Jon is a seasoned executive guiding risk adjustment programs for Medicare Advantage, ACA /Marketplace and Medicaid programs. He brings expertise in development and implementation of effective prospective and retrospective risk adjustment initiatives, appropriately targeted to maximize ROI. He is deeply skilled at guiding and developing analytics to identify/suspect potential risk adjustment opportunities, as well as monitoring for inappropriately coded claims and diagnoses to ensure accuracy in risk adjustment submissions to the MA Encounter Data Processing Systems and ACA Edge Servers. Jon has guided numerous organizations to develop effective controls to reduce data leakage and to manage submission errors.
Prior to joining ACG, Jon served as director of risk adjustment for a multi-state regional health plan that offered ACA /MA and Medicaid products, as well as serving as regional manager for risk adjustment at a national health plan.