Manager, HCC Risk Adjustment Coding

Vanova Health • Verona, NJ

2d • $90,000 - $110,000 • Hybrid

About The Position

The Manager, HCC Risk Adjustment Coding is responsible for overseeing the development and execution of risk adjustment coding education, auditing, and clinical documentation improvement strategies. The Manager will direct and supervise the HCC risk adjustment coders, collaborate with providers, coding teams, and leadership to drive performance improvement, and enhance HCC coding accuracy. The role requires a mix of remote work and travel to physician practices throughout the state of New Jersey. As Vanova continues to grow, this team and role offer great opportunity for growth.

Requirements

• Experience leading a team and collaborating with cross-functional teams.
• Minimum 3 years of experience in risk adjustment coding.
• Strong knowledge of CMS-HCC, HHS-HCC, and ICD-10 coding guidelines.
• Excellent communication and interpersonal skills, with the ability to engage and educate diverse provider audiences.
• Proficiency in EMR/EHR systems and risk adjustment analytics tools.
• Coding Certification - CPC, CRC, CCS-P, CCA, RHIT or RHIA- Required
• Willingness to travel throughout New Jersey (up to 25% travel required).

Nice To Haves

• Experience in provider education, training, or clinical documentation improvement (CDI) is highly preferred.

Responsibilities

• Provide day-to-day leadership and supervision of the HCC Risk Adjustment team, including coders, analysts, and clinical documentation specialists.
• Conduct regular 1:1 meetings, performance reviews, and ongoing feedback to support employee development and engagement
• Develop and implement a comprehensive HCC risk adjustment coding strategy to align with CMS regulations and industry best practices.
• Monitor coding internal and external coding productivity and quality metrics and report on departmental performance.
• Develop and maintain workflows, policies, and standard operating procedures to ensure compliant, efficient, and scalable HCC risk adjustment processes.
• Contribute to annual risk adjustment strategy planning and goal setting.
• Serve as a subject matter expert for risk adjustment in cross-functional initiatives.
• Serve as a liaison between the internal coding team and other departments (e.g., Clinical, IT, Administration) to resolve coding questions and concerns.
• Stay current with CMS updates and changes to HCC risk adjustment coding guidelines to ensure training materials and compliance practices are aligned with the latest regulations.
• Review performance data to identify trends and areas for improvement.
• Develop and deliver comprehensive HCC risk adjustment coding training programs for physicians, nurses, and other healthcare staff.
• Conduct in-person and virtual training sessions, workshops, and webinars to educate providers on the impact of risk adjustment coding.
• Create educational materials like presentations, handouts, and online modules to support coding knowledge and understanding.
• Oversee regular medical record reviews and audits to validate HCC risk adjustment coding accuracy and compliance with CMS guidelines.
• Analyze HCC risk adjustment coding audit results to identify trends and develop targeted educational interventions for providers.
• Partner with physicians and clinical leadership to improve clinical documentation practices, providing feedback and education on necessary documentation enhancements.

Benefits

• Comprehensive benefits based on eligibility include a 401K retirement savings plan with company match, paid time off, and health benefits (medical, prescription drug, dental and vision insurance).
• This position offers an opportunity for annual target bonus based on individual performance and company financial performance.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed