Hybrid Supervisor – Risk Adjustment

at Astrana Health

• Job title: Supervisor – Risk Adjustment
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $90,000 - $105,000 per year
• Degree requirement: High School Diploma
• Location requirements: Hybrid, Orange, United States

About the role

• Risk Adjustment Coding Supervisor at Astrana Health responsible for supervising coding activities and ensuring compliance. Leading a team for efficient Risk Adjustment operations and enhanced healthcare quality.

Responsibilities

• Supervise, coach, and mentor Risk Adjustment Coding Specialists to ensure high-quality, compliant coding practices
• Serve as a resource for coders regarding ICD-10-CM, HCCs, CMS Risk Adjustment guidelines, and documentation standards
• Monitor individual and team productivity, accuracy, and quality metrics; provide ongoing feedback and corrective action as needed
• Utilize productivity, quality, and audit data to identify performance trends, coding gaps, and training opportunities
• Translate data insights into actionable feedback, performance improvement plans, and targeted education
• Assist with onboarding and training of new coding staff
• Support the Risk Adjustment Manager with day-to-day departmental operations, including workflow coordination, prioritization of audits, and issue resolution
• Assist in developing and maintaining standard operating procedures, workflows, and best practices
• Analyze Risk Adjustment data (e.g., recapture rates, audit findings, productivity, denial trends) to support departmental strategy and prioritization
• Collaborate with leadership to design and implement new or enhanced workflows for coders based on data, performance metrics, and operational needs
• Support reporting and dashboard development to track coding performance, quality outcomes, and Risk Adjustment impact
• Escalate operational, compliance, or performance issues to leadership as appropriate
• Review provider documentation and medical records to ensure all Medicare Advantage and Commercial Risk Adjustment requirements are met
• Perform and/or oversee retrospective and prospective medical record reviews to identify, assess, monitor, and document HCC coding opportunities
• Conduct coding quality audits to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation
• Analyze audit results to identify systemic coding or documentation trends and recommend process improvements
• Prepare audit analyses and provide feedback on noncompliance or documentation improvement opportunities
• Interact with physicians and provider office staff regarding coding, billing, and documentation policies and procedures
• Deliver education and training on Risk Adjustment and documentation improvement, both individually and in group settings
• Assist with the development of educational materials and presentations, including PowerPoint content

Requirements

• Certifications
• At least one of the following: CCS, CCS-P, CPC, CPC-H, CPC-P, RHIA, RHIT
• CRC (not required but highly preferred)
• Experience
• Minimum of 4–5 years of medical coding experience, including Risk Adjustment and HCC coding
• Prior lead, senior, or supervisory experience
• Skills & Abilities
• Strong knowledge of Medicare Advantage Risk Adjustment and Hierarchical Condition Categories (HCC)
• Strong data analysis skills with the ability to interpret coding, audit, and performance metrics
• Ability to identify patterns and trends within Risk Adjustment data to inform decision-making and workflow design
• Experience using data to drive operational improvements and support Risk Adjustment initiatives
• Advanced Excel skills preferred (e.g., pivot tables, reporting, data analysis)
• Excellent verbal, written, and presentation skills
• Demonstrated ability to educate and train coding staff and provider office personnel
• Expert-level proficiency in Microsoft Word, Excel, Outlook, and PowerPoint
• Strong organizational, analytical, and problem-solving skills
• Other Requirements
• Reliable transportation and valid driver’s license
• Ability to travel up to 50% of the time within Orange County, Los Angeles County, and the South Bay area.

Benefits

• Our 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.