Head of Risk Adjustment/Coding Operations
New
O
Oasis Health PartnersHealthcare
This role is open to applicants currently residing in the United States.Full-TimeManager
Salary200,000 - 250,000 USD per year
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Job Details
- Experience
- 10+ years experience in Medicare Advantage risk adjustment; 7+ years of experience leading certified coding teams
- Required Skills
- ComplianceChange Management
Requirements
- Bachelor’s degree in healthcare administration, public health, business administration, or related field
- CRC, CPC, CPMA, or equivalent certifications
- 10+ years experience in Medicare Advantage risk adjustment
- Deep expertise in HCC coding, RAF methodologies, and CMS requirements
- 7+ years of experience leading certified coding teams
- Working knowledge of V28 rules and regulations
- Experience evolving risk adjustment programs in dynamic organizations
- Excellent leadership and communication skills
- Change management and continuous improvement experience
Responsibilities
- Define and execute enterprise risk adjustment strategy
- Lead coding operations including staffing, workflows, and training
- Establish performance metrics and reporting
- Partner with clinical and market leaders for provider education
- Collaborate with data and technology teams for automation and analytics
- Mentor and develop the coding team
- Ensure compliance with CMS regulations and coding guidelines
- Implement NLP solutions for coding efficiency
- Develop and maximize Coding Education Platform
- Establish retrospective chart review processes
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