Director, Provider Risk Adjustment

📋 Description

• Lead strategic provider risk adjustment programs for health plans and providers.
• Oversee coding services across domestic and global teams, ensuring quality, productivity, and
• Standardize processes, strengthen coding operations, and support technology and reporting
• Drive client leadership, manage complex relationships, and use performance data to identify risks
• Establish reporting cycles with visibility into performance, risks, trends, and mitigation
• Position the role as a partner for health plans and provider organizations in value-based care

🎯 Requirements

• Bachelor’s degree in Health Information Management, Health Administration, Finance, or related
• 10+ years in medical coding, risk adjustment, or value-based care operations; 5+ years in
• Proven payer-side operations and risk-based healthcare program experience.
• Strong knowledge of HCC coding, provider documentation, data integrity, and regulatory guidelines.
• Experience with global teams, vendors, and multi-client relationships.
• Excellent analytical, problem-solving, and communication skills; proficient with Microsoft Office

🎁 Benefits

• Competitive salary; fully remote position within the United States.
• Medical, dental, and vision insurance; company equipment; 401(k) matching.
• Flexible PTO; family leave; holidays; life and disability insurance; tuition reimbursement.
• Professional development and career growth opportunities; supportive environment for long-term
• Travel less than 25% for quarterly reviews and industry events.