Manager, Risk Adjustment & HEDIS Education

How Youll Make An Impact

At Strive Health patients come first. Were on a mission to transform chronic conditions by identifying risk earlier coordinating thoughtful care and supporting people through every stage of their health journey.

Our work reduces emergency visits improves outcomes and helps patients live fuller lives. Youll work alongside passionate Strivers who care deeply about making an impact show up for one another as One Team and find ways to elevate the everyday.

If youre looking for meaningful work where your contributions truly matter youll feel right at home at Strive!

Benefits & Perks

• 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 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.

To learn more about our offerings click here.

What Youll Do

Strive Health is looking for a collaborative provider-facing leader to own and scale provider education strategies and improve documentation quality coding accuracy audit readiness and value-based performance across Strive. The Manager Risk & HEDIS Education will partner across Risk Adjustment Quality Clinical Operations Compliance Informatics and provider-facing stakeholders to design and deliver standardized education programs that helps providers documentaccurateand compliant patient complexity while supporting quality and audit readiness. This role will translate organizational priorities into provider-friendly workflows targeted coaching and actionable feedback that improves performance across markets. This individual would report to the Senior Director RiskAdjustmentand HEDIS Enablement.

The Day to Day

• Lead the development and delivery of provider education programs focused on risk adjustment HCC documentation ICD-10-CM coding principles HEDIS quality measures and documentation best practices for employed and contracted provider groups.
• Set goals timelines and performance expectations for the education initiatives and ensure work is aligned to departmental priorities market needs and enterprise standards.
• Serve as a primary subject matter resource to operational teams on documentation requirements coding guidelines CMS regulations audit readiness and value-based care performance expectations.
• Conduct prospective and retrospective documentation and coding reviews toidentifytrends educational opportunities provider-specific gaps and areas for workflow improvement.
• Develop standardized education materials feedback mechanisms tip sheets playbooks and training curricula to support provider onboarding ongoing education and scalable adoption across markets.
• Provide targeted coaching and performance feedback to providers provider groups and market partners based on audit findings documentation trends coding reviews and quality performance opportunities.
• Partner with Risk Adjustment Quality Clinical Operations Compliance Legal and Coding leadership to ensure provider-facing guidance is practical consistent and aligned with organizational standards.
• Monitor provider group and market-level documentation and coding trends and develop reporting and recommendations that support accountability continuous improvement and stronger value-based performance.
• Support workflow and technology optimization efforts by partnering with Informatics Product EHR and operational teams to embed documentation and coding requirements into provider workflows and education.
• Support change management and education for new documentation workflows tools and process enhancements that improve documentation quality coding accuracy provider experience and operational efficiency.
• Meet in person with internal and/or external stakeholders tofacilitateteam and business priorities and opportunities. Business travel may berequiredfor opportunities to connect with stakeholders serve patients and attend Strive-sponsored team events.

Minimum Qualifications

• Bachelors degree in healthcare administration nursing public health health information management healthcare management ora relatedfield. Equivalent combinations of education and experience may be considered.
• 4 years of experience or certification in risk adjustment medical coding clinical documentation improvement provider education auditing quality improvement or related healthcare disciplines.
• Active Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) certification.
• Demonstrated experience delivering education coaching and training to physicians advanced practice providers and clinical teams.
• Strong knowledge of Medicare Advantage risk adjustment methodologies HCC models CMS regulations and ICD-10-CM coding guidelines.
• Knowledge of HEDIS Stars quality programs and healthcare analytics.
• Demonstrated experience analyzing documentation coding quality or performance data and translating findings into targeted education and improvement strategies.
• Strong presentation facilitation communication and relationship-building skills with the ability to work effectively across providers operational leaders network partners and cross-functional teams.
• Ability to travel and be onsite to meet business needs.
• Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60ms.
• Efficient and reliable transportation including an active drivers license allowing for travel across an assigned region to meet business needs.

Preferred Qualifications

• Experience supporting value-based care population health managed care accountable care or delegated provider programs.
• Experience conducting coding audits provider feedback reviews clinical documentation improvement initiatives or provider performance education.
• Experience supporting EHR optimization provider workflow redesign or implementation of documentation support tools.
• Certified Professional Medical Auditor (CPMA) Certified Coding Specialist (CCS) Certified Coding Specialist - Physician-based (CCS-P) RHIA RHIT CDEO CCDS or CCDS-O preferred.

About You

• You are an effective educator who can translate complex coding documentation and regulatory requirements into clear provider-friendly guidance.
• You are comfortable balancing relationship-building with accountability and can deliver feedback in a way that drives improvement and trust.
• You are highly organized adaptable and able to manage multiple priorities across provider groups markets and cross-functional stakeholders.
• You bring sound judgment curiosity and problem-solving skills and canidentifypractical opportunities to improve workflows education and performance.
• You thrive in a fast-paced evolving environment and are motivated by building scalable programs that improve both provider experience and organizational outcomes.

Annual Base Salary Range: $85500 - $104000

Final compensation will be determined based on location experience and qualifications.

Strive Health is an equal opportunity employer and drug free workplace. At this time Strive Health is unable to provide work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability status protected veteran status or any other characteristic protected by law. Please apply even if you feel you do not meet all qualifications. If you require reasonable accommodation in completing this application interviewing completing any pre-employment testing or otherwise participating in the employee selection process please direct your inquiries to

We do not accept unsolicited resumes from outside recruiters/placement agencies. Strive Health will not pay fees associated with resumes presented through unsolicited means.