Senior Vice President, Healthcare Analytics & Risk Adjustment Solutions
Jessica Smith is Senior Vice President of Healthcare Analytics & Risk Adjustment Solutions at Gorman Health Group (GHG). In this role, she is responsible for the execution and oversight of risk adjustment consulting services for managed care, provider practice, and commercial market clients and leading and integrating cross-functional teams to ensure superior performance outcomes related to risk adjustment operations.
Jessica brings GHG clients 15 years of healthcare experience as one of the nation’s leading experts on risk adjustment. She has experience developing strategies, initiatives, coding compliance, and end-to-end support for risk adjustment operations for Medicare Advantage, managed Medicaid, commercial markets, and physician groups.
Prior to joining the GHG team, Jessica was accountable for enterprise risk adjustment and led health plan efforts to implement commercial risk adjustment operations and technical support. In this role, Jessica was responsible for the overall strategy, design, and performance of the risk adjustment program. She led a cross-functional technical team of data analysts, solution architects, developers, testers, and business colleagues to implement all Affordable Care Act (ACA) data needs throughout the organization. Jessica also worked with the Centers for Medicare & Medicaid Services (CMS) and contracted vendors to establish EDGE Server edits and corresponding reports.
In addition to risk adjustment, Jessica also brings strong experience developing and operationalizing data governance, regulatory compliance, and vendor management. For the past decade, she has been focused on public-private healthcare market interactions, all in the context of an ongoing analysis of key financial and public policy trends as they impact profitability in the industry. Jessica is passionate about the healthcare industry and delivering quality care to all members.
Jessica received her Bachelor of Science degree from the University of South Florida.