Director Risk Adjustment Remote

Responsibilities: Lead a large department of risk adjustment coders and auditors while serving as the primary operational partner for external healthcare clients. Ensure regulatory alignment with CMS-HCC guidelines and collaborate with product teams to optimize AI-enabled coding solutions.

Requirements: Requires 9+ years of risk adjustment experience, including 3-5 years managing a workforce of 50+ staff. A bachelor's degree and CRC certification are highly preferred, along with expert knowledge of Medicare risk coding models.

Key skills: Strategic Client Management, Team Leadership, Operational Excellence, Regulatory Compliance, CMS-HCC Coding, Risk Adjustment, Data-Driven Decision Making, Product Collaboration, KPI Monitoring, Auditing, Resource Planning, Stakeholder Management

Keywords: CMS-HCC, Risk Adjustment, CRC, CPMA, CPC, CCS, RHIA, Medicare, Medicaid, ACA, RADV, HHS-RADV, OIG Mandates, Health Information Management, AI-powered Automation, EDS, RAPS, Medical Coding, Medical Auditing, Healthcare Operations