Director, Provider Risk Adjustment

Location: Remote – US-based candidates only, no visa sponsorship available

Compensation: $120,000 – $150,000 annually

About the role

This role will provide business-aligned guidance focused on governance, compliance, and operational risk management. You will partner with leaders, compliance stakeholders, and cross-functional teams to translate complex issues into practical recommendations. The position offers the opportunity to strengthen responsible execution, improve decision-making, and support sustainable growth within a healthcare environment.

Responsibilities

• Serve as primary strategic lead for assigned clients
• Oversee implementation of new clients, including onboarding and process mapping
• Maintain accountability for coding quality and project deliverables
• Lead client meetings and ensure transparency in communications
• Monitor team productivity and implement performance improvement plans
• Ensure organizational compliance with coding standards and policies
• Identify best practices and enhance operational workflows for efficiency

Qualifications

• Bachelor's degree in Health Information Management or related field; Master's preferred
• 10+ years in medical coding or value-based care operations, with 5+ in leadership
• Experience with Payer-side operations and risk-based programs
• Strong understanding of HCC coding practices and regulatory guidelines
• Ability to manage global teams and vendor relationships
• Proficient in MS Office and data analysis tools

Benefits

• Medical/Dental/Vision Insurance
• 401k matching program
• Flex Unlimited Annual PTO
• Paid Paternity & Maternity leave
• Tuition reimbursement
• Life Insurance
• Short and long term disability options