Director, Risk Coding Operations

Strive Health • Denver, CO

9d • Hybrid

About The Position

The Director, Risk Coding Operations will oversee internal coding teams and external coding or billing vendors, establish scalable operational processes, and ensure strong internal controls across end-to-end risk coding workflows. This role partners closely with clinical, analytics, compliance, and enablement teams to operationalize strategy through disciplined execution.

Requirements

• Bachelor’s degree.
• 8+ years of experience in healthcare operations, managed care, or revenue cycle functions.
• 7+ years of experience in risk adjustment coding operations, medical record review, audits, or related functions.
• Certified Risk Adjustment Coder (CRC) – required.
• Strong working knowledge of ICD-10, HCC coding models, and CMS risk adjustment requirements.
• Experience managing external coding or billing vendors.
• Ability to travel and be onsite as business needs require.
• Reliable internet connectivity meeting minimum technical requirements.
• Efficient and reliable transportation allowing for the ability to commute to hospitals.
• Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms.

Nice To Haves

• Master’s degree in healthcare administration, business, finance, or related field.
• 4+ years of people management experience leading operational teams.
• CPC, CPMA, or other advanced coding or audit certifications.
• Experience supporting Medicare Advantage, CMMI, and other value-based care models.
• Prior experience in an MSO or risk-bearing organization.
• Strong operational discipline with ability to build scalable, repeatable processes.

Responsibilities

• Lead risk coding operations across prospective and retrospective workflows, including chart review, coding, audits, and remediation.
• Own operational performance metrics including coding accuracy, turnaround times (TATs), productivity, audit outcomes, and rework rates.
• Oversee external retrospective coding, audit, and billing vendors, ensuring contracted deliverables, quality standards, and timelines are met.
• Establish and maintain operational workflows supporting ASM processing, reconciliations, and end-to-end data leakage review.
• Partner with compliance and legal teams to ensure adherence to CMS risk adjustment requirements and internal audit standards.
• Develop and maintain operational controls to support compliant, defensible coding and submission readiness.
• Lead investigation and resolution of coding discrepancies, reconciliation issues, and operational root causes.
• Collaborate with analytics teams to monitor coding trends, accuracy, and risk capture performance over time.
• Partner with clinical leadership and provider-facing teams to support operational resolution of documentation or coding questions.
• Design and implement scalable processes that support future expansion into broader revenue cycle management (RCM) functions.
• Build and mentor high-performing operational teams, fostering accountability, consistency, and continuous improvement.

Benefits

• Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home visits.
• Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts.
• Financial & Retirement Support – Competitive compensation with a performance-based discretionary bonus program, 401k with employer match, and financial wellness resources.
• Time Off & Leave – Paid holidays, vacation time, sick time, and paid birthgiving, bonding, sabbatical, and living donor leaves.
• Wellness & Growth – Family forming services through Maven Maternity at no cost and physical wellness perks, mental health support, and an annual professional development stipend.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 501-1,000 employees