Director of Medical Risk Adjustment & Clinical Documentation

Valora Medical Group; Orlando (FL); On-site; USD 140,000 - 180,000; Full time

Job summary

Valora Medical Group is seeking a Director of Medical Risk Adjustment (MRA) and Clinical Documentation to lead our coding and documentation strategy. This role oversees internal risk coding operations, ensures CMS/HHS compliance, and drives provider performance through education and quality initiatives.

The ideal candidate has deep MRA, coding, and regulatory experience, and will work cross-functionally with Care Management, Clinical Ops, Providers, and Leadership to optimize coding accuracy and

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, or Management.
• Master's degree preferred.
• Bilingual in English and Spanish highly preferred.
• 7+ years in management, healthcare industry.
• 5+ years in MRA coding and clinical documentation.
• Knowledge of EMR systems - eClinicalWorks (eCW) experience required.
• Proficient in Microsoft Office 365 (Outlook, PowerPoint, Excel, Word).
• Understanding CMS Fraud/Waste/ Abuse, OSHA, and HIPAA expectations.
• Strong written, verbal communication and interpersonal skills.

Responsibilities

• Direct day-to-day operations of the MRA and Clinical Documentation team.
• Manage hiring, coaching, performance management, and professional development.
• Foster a culture of compliance, integrity, accountability, and Valora’s core behaviors.
• Oversee risk adjustment audit processes and validation of diagnosis codes.
• Ensure CMS/HHS and federal/state regulatory compliance.
• Design and deliver provider education to improve documentation and coding accuracy.
• Lead QA for risk adjustment coding and monitor productivity and accuracy.

Skills

Leadership

People management

Communication skills

Bilingual English/Spanish

Analytical skills

Healthcare industry knowledge

Education

Bachelor's degree in Healthcare Administration/Business Administration/Management

Master's degree preferred

AAPC CPC certification

Tools

eClinicalWorks (eCW)

Microsoft Office 365

Job description

Valora Medical Group is seeking a Director of Medical Risk Adjustment (MRA) and Clinical Documentation to lead our coding and documentation strategy. This role oversees internal risk coding operations, ensures CMS/HHS compliance, and drives provider performance through education and quality initiatives.

The ideal candidate has deep MRA, coding, and regulatory experience, and will work cross-functionally with Care Management, Clinical Ops, Providers, and Leadership to optimize coding accuracy and