Manager, Risk Adjustment Coding and Documentation Education

Who You Are 

You are a seasoned professional with extensive experience in Medicare Advantage Risk Adjustment, combining in-depth coding expertise, comprehensive knowledge of documentation standards, and a proven ability to lead and educate diverse teams to drive compliance and performance excellence. Your attention to detail ensures accurate documentation to reflect the overall health of each member. You are excited to join a new company dedicated to supporting Primary Care Providers (PCPs) in rural markets. 

Who We Are

Oasis Health (Oasis) is building healthier communities by advancing primary care.  We partner with patients, providers and plans to provide personalized, local care for seniors in towns across America.  We believe that patient needs come first, and that primary care is the foundation of patient-centric healthcare. With Oasis, patients receive better access and care. Providers receive the data, resources and expertise to be successful in value-based care arrangements. Payors get the benefit of a solution that improves performance, drives growth and reduces the total cost of care in hard-to-engage markets.   

Together, we will boldly advance primary care for those that need it most. We are excited for you to join us on this journey. We invite you to be a part of Oasis, where you’ll discover we do the right thing, build things together and go all in --- all while having fun! 

Your Role 

The Medicare Risk Adjustment Coding and Documentation Education Manager is a hands-on leader responsible for developing and managing education and training initiatives to ensure accurate, compliant coding and documentation for Medicare Advantage plans. This role focuses on optimizing reimbursement, mitigating risk, and improving documentation accuracy by actively contributing to coding and documentation processes as a working manager. The manager will collaborate closely with healthcare providers, market teams, coding staff, and compliance teams to align strategies, enhance documentation practices, and educate stakeholders. Additionally, the manager will track and analyze key performance indicators (KPIs) to drive continuous improvement and operational excellence. 

Additional responsibilities:

• Lead the development and delivery of training programs to educate providers, coders, and other healthcare staff on Medicare Risk Adjustment coding guidelines
• Oversee the implementation of coding education strategies to ensure adherence to Medicare Risk Adjustment protocols.
• Serve as a subject matter expert for Medicare Risk Adjustment coding and documentation policies; develop and maintain up to date protocols 
• Interview, hire, and lead a team of coding educators, ensuring quality training, delivery and performance
• Develop, maintain, and deliver comprehensive education programs covering ICD-10 coding, HCC (Hierarchical Condition Category) coding, risk adjustment methodologies, and CMS regulations
• Conduct regular training sessions, workshops, webinars, and one-on-one sessions for providers, coders, and documentation specialists
• Provide guidance and support to healthcare professionals on best practices for accurate coding and documentation to ensure the highest levels of compliance and risk adjustment accuracy
• Ensure that all coding and documentation practices comply with federal regulations, including CMS (Centers for Medicare and Medicaid Services) and Medicare Advantage guidelines
• Regularly audit coding and provider education materials and documentation for accuracy and completeness, providing feedback to improve quality
• Collaborate with clinical, compliance, and operational teams to ensure that training materials align with organizational goals and meet regulatory standards
• Act as a liaison between the coding team and clinical providers, fostering open communication about documentation and coding challenges
• Present coding and documentation findings to senior management and provide strategic recommendations for improving risk adjustment processes
• Monitor risk adjustment performance metrics and identify areas of improvement in coding and documentation practices.
• Provide detailed reports on coding education activities, compliance audits, and training outcomes to senior leadership
• Participate as an active member of the Oasis central Clinical Operations leadership team. Engage directly with Oasis cross-functional teams and market operations to review PCP performance, analyze data, and operationalize strategies for improvement 

Investment In Our Team 

We invest in the personal and professional success of our team. We take care of our people and offer robust benefits including medical, dental, vision and generous time off plans. We are committed to supporting your growth with a development program that starts with onboarding and continues throughout your career. As an inclusive, passionate and diverse team, you will partner with professionals who understand the importance of high-value, high-impact patient care.   

About You 

• Hold an associate’s degree with an active coder certification (CCS, CCS-P, CPC) bachelor's degree preferred 
• Have five years of experience working in Medicare Advantage Risk Adjustment
• At least two years of previous leadership experience
• Have a passion for quality healthcare 
• Prior experience in coding quality auditing, and compliance within a healthcare setting
• Experience and comfort with direct clinician engagement, including relationship building and clinical documentation education
• Demonstrated ability to work independently and deliver results 
• Strong communication skills and interpersonal skills with the ability to collaborate effectively with diverse stakeholders
• Ability to code using an ICD-10-CM code book (without using an encoder)
• Knowledge of HIPAA, commitment to privacy, security and confidentiality 
• Strong clinical knowledge related to chronic illness diagnosis, treatment and management

2025 Key Accomplishments

• Achieve and Sustain Coding Accuracy Targets
• Ensure coding accuracy rates meet or exceed organizational and regulatory benchmarks by implementing robust training programs, conducting regular audits, and providing actionable feedback to teams and providers
• Enhance Documentation Quality and Provider Engagement
• Improve provider documentation quality through targeted education, streamlined processes, and tools that simplify compliance, resulting in measurable improvements in completeness and specificity
• Track and Improve Key Performance Indicators (KPIs) - Establish and maintain a dashboard of KPIs related to coding accuracy, compliance, and financial performance. Use this data to identify trends, address gaps, and demonstrate year-over-year improvements
• Build Cross-Functional Collaboration Frameworks - Develop and strengthen partnerships with market teams, compliance, and coding staff to align risk adjustment efforts across the organization. Ensure clear communication and shared accountability for outcomes.
• Maximize Cozeva Tool Utilization - Fully leverage Cozeva to optimize workflows, identify documentation gaps, and enhance collaboration between providers and coding teams. Ensure the tool is utilized effectively to drive compliance, improve performance metrics, and streamline risk adjustment processes

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status, or disability status