Risk Coding Manager — Medicare & Medicaid ACO Lead

Community-Care-Cooperative; Greater London; On-site; GBP 68,000 - 82,000; Full time

Job summary

Community Care Cooperative (C3) is seeking a Manager of Risk Coding to lead a team delivering retrospective and prospective risk coding for FQHCs and partner networks under MassHealth ACO and Medicare ACO MSSP contracts. The role requires expertise in ICD-10-CM guidelines, risk adjustment methodologies, and strong leadership with experience in Epic/NextGen/Centricity/eCW environments.

The position focuses on improving documentation accuracy and coding quality while ensuring compliance and timely

Qualifications

• 5+ years risk coding experience in healthcare.
• Experience supporting Medicare ACO risk adjustment programs (MSSP) or CMS-HCC.
• Experience with Medicaid risk adjustment models (DxCG) and MassHealth context.
• 5+ years medical billing experience in outpatient settings (primary care, pediatrics or behavioral health).
• 2–4 years leadership experience managing coding teams and productivity/quality targets.
• Knowledge of billing compliance and auditing processes.

Responsibilities

• Oversee coding team delivering risk adjustment for FQHCs and MSSP/MassHealth contracts.
• Ensure documentation supports CMS-HCC Version 28 and DxCG models.
• Conduct internal audits to assure coding quality and accuracy.
• Develop provider reports and feedback loops for coding improvements.
• Lead hiring, onboarding, and training for coding staff.
• Monitor productivity metrics, turnaround times, and reporting commitments.
• Coordinate with Education, Quality, Population Health, and Billing teams.

Skills

Risk coding

Medicare ACO MSSP

Medicaid risk adjustment DxCG

Medical billing

Leadership

CMS knowledge

Population health

Education

Bachelor’s degree in healthcare or related field

CPC/CCS/CRC certifications

Tools

Epic

NextGen

Centricity

eCW

Arcadia

Milliman

MS Office

Job description

Community Care Cooperative (C3) is seeking a Manager of Risk Coding to lead a team delivering retrospective and prospective risk coding for FQHCs and partner networks under MassHealth ACO and Medicare ACO MSSP contracts. The role requires expertise in ICD-10-CM guidelines, risk adjustment methodologies, and strong leadership with experience in Epic/NextGen/Centricity/eCW environments.

The position focuses on improving documentation accuracy and coding quality while ensuring compliance and timely