Manager, HCC Risk Adjustment Coding

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. 

ESSENTIAL DUTIES AND RESPONSIBILITIES (included but not limited to):

Leadership & Team Management

• 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.

Education & Training Program Management 

• 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.

HCC Compliance Monitoring

• 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.

REQUIRED SKILLS & QUALIFICATIONS:

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

WORK ENVIRONMENT/PHYSICAL DEMANDS

• Office setting, with extended periods of sitting and computer work
• Willingness to travel throughout New Jersey (up to 25% travel required).

TOTAL REWARDS AT VANOVA HEALTH SOLUTIONS:

At Vanova, we see Total Rewards as more than just a paycheck and recognize that value comes in many forms. It is the full experience of being a part of our incredible team working toward a shared, mission-driven purpose.  We’re proud to offer competitive compensation, health and wellness benefits, a retirement savings plan, time off to recharge, learning opportunities to continually grow, and meaningful work in a collaborative culture that fosters team connection through shared celebrations and appreciation events.

We are committed to investing in the future of our people and focused on expanding our total rewards to support every stage of your journey with us.

• The anticipated base annual salary for this role ranges from $90,000 - $110,000.
• This position offers an opportunity for annual target bonus based on individual performance and company financial performance.
• 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).
• Please note that individual total compensation for this position will be determined at the Company’s sole discretion and may vary based on several factors, including but not limited to location, skill level, years and depth of relevant experience, and education.

EEOC Statement: Vanova Health is an Equal Opportunity Employer. We are committed to creating a diverse and inclusive environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

This job description is intended to describe the general nature and level of work performed and is not an exhaustive list of all responsibilities, duties, and skills associated with it. Duties and expectations may be subject to change with or without notice.

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