Director, Risk & HEDIS Enablement

Strive Health • Denver, CO

2h • Hybrid

About The Position

Strive is seeking a Director, Risk & HEDIS Enablement to lead the development, optimization, and adoption of risk adjustment and HEDIS-related processes across the organization. This role is responsible for enabling clinical teams to perform effectively through education, systems optimization, performance insights, and operational alignment across risk and quality initiatives.

The Director, Risk & Quality Enablement focuses on translating strategy into practice, ensuring clinicians and field teams are equipped with clear guidance, effective tools, and actionable insights to support accurate documentation and quality performance.

Requirements

• Bachelor’s degree.
• 8+ years of experience in healthcare operations, clinical enablement, quality, or managed care.
• 7+ years of experience supporting risk adjustment, HEDIS, or quality improvement initiatives.
• Strong understanding of CMS risk adjustment and quality measurement principles.
• Experience working directly with clinical teams and providers.
• 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, or related field.
• 4+ years of leadership experience in cross-functional or matrixed environments.
• Clinical, coding, or quality certification (e.g., RN, CRC, CPHQ).
• Experience in value-based care or MSO environments.
• Strong change-management and communication skills.
• Ability to translate complex requirements into clear, clinician-friendly guidance.
• Proven ability to build alignment across diverse stakeholders in fast-paced environments.

Responsibilities

• Lead the design and execution of risk adjustment and HEDIS enablement strategies, including education, tools, and workflow optimization.
• Develop clinician-facing education and guidance that translates coding and quality requirements into practical documentation practices.
• Partner with technology, analytics, and operations teams to optimize systems, POCT workflows, and suspecting processes.
• Own performance management frameworks that track adoption, engagement, and effectiveness of risk and quality initiatives.
• Identify gaps in process, system configuration, or data integrity that impact documentation or quality outcomes and drive resolution.
• Collaborate with clinical leadership and field teams to reinforce consistent risk and quality practices across markets.
• Support vendor management related to enablement tools, quality platforms, or data solutions.
• Partner with Risk Coding Operations to ensure alignment between enablement efforts and operational coding outcomes.
• Lead troubleshooting and root-cause analysis related to documentation gaps, workflow breakdowns, or system limitations.
• Drive alignment across departments to improve execution of risk and quality strategy.
• Build scalable education and enablement models that support growth and evolving CMS requirements.

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: Mid Level
• Number of Employees: 501-1,000 employees