Senior Director, Risk Adjustment & Clinical Documentation

Wellvana; Nashville (TN); On-site; USD 180,000 - 240,000; Full time

Job summary

Wellvana in Nashville is seeking a Senior Director of Accurate Clinical Documentation to oversee risk adjustment coding/auditing and provider education initiatives across MSSP and MA programs.

The role includes supervising two direct reports and a 23-person organization, managing two vendor relationships, ensuring CMS risk adjustment compliance, and driving strategic programs with data-driven results.

Qualifications

• 10+ years of risk adjustment leadership experience.
• Master's degree preferred in healthcare administration.
• CRC and CPC certifications preferred.

Responsibilities

• Lead risk adjustment strategy and vendor relationships for accuracy and compliance.
• Oversee creation of education materials for clinical documentation providers.
• Ensure CMS risk adjustment compliance and regulatory alignment.
• Recruit, mentor, and lead a 23-person team across multiple functions.
• Provide regular analytics and reporting to senior leadership.

Skills

Risk adjustment leadership

Vendor management

Clinical documentation

Regulatory compliance

Data analysis

Team leadership

Education program development

Education

Master's in Healthcare Admin

CRC & CPC certifications

Job description

Wellvana in Nashville is seeking a Senior Director of Accurate Clinical Documentation to oversee risk adjustment coding/auditing and provider education initiatives across MSSP and MA programs.

The role includes supervising two direct reports and a 23-person organization, managing two vendor relationships, ensuring CMS risk adjustment compliance, and driving strategic programs with data-driven results.