Supervisor - Risk Adjustment

Supervisor - Risk AdjustmentDepartment: Quality - Risk AdjustmentEmployment Type: Full TimeLocation: 600 City Parkway West 10th Floor, Orange, CA 92868Reporting To: Yuvone Washington-OshonCompensation: $90,000 - $105,000 / yearDescriptionWe are seeking an experienced and motivated Risk Adjustment Coding Supervisor to oversee and support a team of Risk Adjustment Coders. This role is responsible for supervising daily coding activities, ensuring accuracy and compliance with CMS Risk Adjustment guidelines, and supporting the Manager with day-to-day operations of the Risk Adjustment department.The Supervisor will serve as a subject matter expert in HCC coding, provide guidance and mentorship to coding staff, assist with auditing and quality initiatives, and help drive departmental performance to ensure accurate CMS payment and improved quality of care.The ideal candidate will also be highly data-driven, with the ability to analyze coding, audit, and performance data to identify trends, gaps, and opportunities. This role will leverage data insights to support Risk Adjustment initiatives, improve coder performance, and help design and implement new or enhanced workflows that drive efficiency, accuracy, and optimal HCC capture.*This role requires some travel - please refer to job description below.Our Values:Put Patients FirstEmpower Entrepreneurial Provider and Care TeamsOperate with Integrity & ExcellenceBe InnovativeWork As One TeamWhat You'll DoTeam Leadership & SupervisionSupervise, coach, and mentor Risk Adjustment Coding Specialists to ensure high-quality, compliant coding practicesServe as a resource for coders regarding ICD-10-CM, HCCs, CMS Risk Adjustment guidelines, and documentation standardsMonitor individual and team productivity, accuracy, and quality metrics; provide ongoing feedback and corrective action as neededUtilize productivity, quality, and audit data to identify performance trends, coding gaps, and training opportunitiesTranslate data insights into actionable feedback, performance improvement plans, and targeted educationAssist with onboarding and training of new coding staffOperational SupportSupport the Risk Adjustment Manager with day-to-day departmental operations, including workflow coordination, prioritization of audits, and issue resolutionAssist in developing and maintaining standard operating procedures, workflows, and best practicesAnalyze Risk Adjustment data (e.g., recapture rates, audit findings, productivity, denial trends) to support departmental strategy and prioritizationCollaborate with leadership to design and implement new or enhanced workflows for coders based on data, performance metrics, and operational needsSupport reporting and dashboard development to track coding performance, quality outcomes, and Risk Adjustment impactEscalate operational, compliance, or performance issues to leadership as appropriateCoding, Auditing & ComplianceReview provider documentation and medical records to ensure all Medicare Advantage and Commercial Risk Adjustment requirements are metPerform and/or oversee retrospective and prospective medical record reviews to identify, assess, monitor, and document HCC coding opportunitiesConduct coding quality audits to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentationAnalyze audit results to identify systemic coding or documentation trends and recommend process improvementsPrepare audit analyses and provide feedback on noncompliance or documentation improvement opportunitiesProvider & Staff EducationInteract with physicians and provider office staff regarding coding, billing, and documentation policies and proceduresDeliver education and training on Risk Adjustment and documentation improvement, both individually and in group settingsAssist with the development of educational materials and presentations, including PowerPoint contentQualificationsCertificationsCertified Coding Specialist (CCS or CCS-P) OR Certified Professional Coder (CPC)Certified Risk Adjustment Coder (CRC) (not required but highly preferred)ExperienceMinimum of 4-5 years of medical coding experience, including Risk Adjustment and HCC codingPrior lead, senior, or supervisory experienceSkills & AbilitiesStrong knowledge of Medicare Advantage Risk Adjustment and Hierarchical Condition Categories (HCC)Strong data analysis skills with the ability to interpret coding, audit, and performance metricsAbility to identify patterns and trends within Risk Adjustment data to inform decision-making and workflow designExperience using data to drive operational improvements and support Risk Adjustment initiativesAdvanced Excel skills preferred (e.g., pivot tables, reporting, data analysis)Excellent verbal, written, and presentation skillsDemonstrated ability to educate and train coding staff and provider office personnelExpert-level proficiency in Microsoft Word, Excel, Outlook, and PowerPointStrong organizational, analytical, and problem-solving skillsOther RequirementsReliable transportation and valid driver's licenseAbility to travel up to 50% of the time within Orange County, Los Angeles County, and the South Bay area.You're great for the role if:Have deep expertise in Risk Adjustment and HCC codingAre data-driven and comfortable using metrics to guide decisions and improve outcomesEnjoy analyzing trends and patterns to enhance Risk Adjustment performanceHave experience building or refining workflows that improve coder efficiency and accuracyEnjoy leading, mentoring, and developing coding professionalsThrive in a fast-paced, collaborative environmentAre detail-oriented and committed to coding accuracy and complianceAre comfortable supporting management with operational and workflow needsEnvironmental Job Requirements and Working ConditionsOur organization follows a hybrid work structure where the expectation is to work both onsite and at home on a weekly basis. Up to 50% travel is required in designated market(s).The home office of this department is located at 600 City Parkway West, 10th Floor, Orange, CA 92868.The total compensation target pay range for this role is $90,000 - $105,000 per year. The salary range represents our national target range for this role. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.Additional Information: