Risk Adjustment Coding Manager

Broomfield

Friday, 24 April 2026

The Manager of Risk Adjustment Coding is responsible for the oversight of the HCC Coding Analyst team. The manager plays a critical role in development and execution of coding policies and compliance with government regulations. This position is required to work in a matrixed environment and is responsible for HCC coding activities to support accurate and complete coding within our network provider community. Additional responsibilities including goal setting, business planning and contributing participation in strategic initiatives. Responsibilities to include:Sets team direction, resolves problems and provides guidance to members of team. Provides key input to other departments responsible for coding education. Works with risk adjustment leadership to develop strategies and processes for all risk adjustment models. Monitor productivity and implement solutions to optimization coding department. Quantify ROI on coding products and projects. Develops, deploys & monitors coding policies and procedures, standards, best practice models for complete, accurate, consistent and timely coding that results in. Conduct HCC coding roundtable discussion as needed. Hire, oversight all coding caregivers within team. Manages all aspects of retrospective review process including oversight of third party contracted vendor, chart abstraction projects and compliance oversight. Primary accountable contact for vendor contracts supporting HCC coding including contract negotiation, setting goals, and tracking performance, and analyzing ROI - Develop team metrics that align with organization strategic initiatives and drive performance. Engage staff in problem solving and process improvement activities to ensure use of resources, and optimal, accurate diagnosis HCC capture. Improve monitoring and auditing protocols to ensure internal and vendor compliance with all applicable regulations and risk adjustment data validation audits (RADV). Respond to and oversee CMS Risk Adjustment Data Validation (RADV) audit requests. Responsible for development of competencies for measuring staff performance and implements action plans based on findings of education/reviews. Cultivates and maintains partnerships and collaborations with internal and external business partners. Minimum Qualifications. Certified Coding certification through AHIIMA or AAPC - Demonstrated risk adjustment coding experience. Demonstrated experience in HCC coding. Preferred Qualifications. Previous managerial experience. Bachelor’s degree Demonstrated experience in a Leadership role.

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