Source Job

US

  • Lead the building and scaling of risk adjustment operations, including defining workflows and integrating into care delivery.
  • Drive broader clinical operations initiatives to improve care delivery workflows and cross-team coordination.
  • Translate strategic priorities into operational workplans, establish KPIs, and support performance visibility.

Risk Adjustment HCC Coding Clinical Operations Population Health Data Analysis

5 jobs similar to Manager, Risk Adjustment & Clinical Operations

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United States Unlimited PTO

  • Drive operational excellence across provider risk adjustment, HCC coding, and value-based care programs while overseeing coding services delivered by domestic and global teams.
  • Serve as the primary strategic lead and escalation point for health plan and provider clients, maintaining accountability for service quality and client satisfaction.
  • Manage, mentor, and develop diverse coding teams across locations, ensuring coding activities follow organizational standards and regulatory requirements.

Our partner is a company that drives operational excellence in healthcare through risk adjustment, HCC coding, and value-based care programs. They are a senior leadership focused organization that manages coding services with diverse teams, emphasizing quality and compliance.

US

  • Lead operations of the CDI team for prospective and concurrent chart review, ensuring quality, accuracy, and compliance.
  • Coach and develop specialists through onboarding, training, performance management, and workflow improvement.
  • Partner with physicians and operational teams to sustain accurate CMS-HCC documentation and audit readiness.

Greenbrook Medical delivers high-touch, relationship-based primary care for seniors through neighborhood clinics. They are in a growth phase, backed by strong unit economics and a culture of Heart, Excellence, Accountability, Resilience, and Teamwork.

US

  • Manage quality initiatives and operational processes for value-based care programs. - Analyze data and support reporting functions across ACO programs. - Serve as liaison between providers, vendors, and internal stakeholders.

Curana Health is a national leader in value-based care for senior living communities and skilled nursing facilities, offering on-site primary care and Medicare Advantage plans. Founded in 2021, the company serves over 200,000 seniors across 32 states with a team of more than 1,000 clinicians and support staff, and was ranked #147 on the Inc. 5000 list.

$87,700–$157,800/yr
US

  • Lead clinical quality, quality improvement, and risk adjustment programs in a managed care environment.
  • Analyze performance data to identify trends, gaps, and opportunities for improved care and cost reduction.
  • Provide people leadership, coaching, and development to clinical and quality team members.

Our partner is a healthcare organization focused on improving access, quality, and outcomes. They operate in a managed care environment with a collaborative, purpose-driven culture.

US

  • Architect and scale a unified Central Operations hub for dual-revenue engine optimization, including Fee-For-Service and Value-Based Care workflows.
  • Own ancillary services such as Medical Records, Lab Integrations, and Referral Management while driving facility partner onboarding and B2B integration.
  • Oversee telemedicine team deployment for footprint support and create executive dashboards to monitor provider productivity and operational outcomes.

Theoria Medical provides telemedicine and operational services to post-acute care facilities, including skilled nursing and assisted living communities. The company is scaling a centralized operations hub to support multi-state growth, though specific employee size is not disclosed.