Sr. Manager, HCC Coding & Quality Auditor

Salud Healthcare; Fort Lauderdale (FL); On-site; USD 150,000 - 190,000; Full time

Job summary

Salud Healthcare is seeking a Sr. Manager of HCC Coding & Quality Auditor / Educator to lead audits and educate providers across coding, risk adjustment, and quality management.

You will collaborate with clinicians to translate findings into clear feedback, strengthening risk adjustment accuracy and quality performance. In this dual-focused role, you will oversee a team of 3–5 auditors, drive continuous improvement, and ensure compliance with CMS guidelines while advancing program outcomes in

Qualifications

• 2–3+ years of experience auditing providers and delivering education.
• Hands-on with HEDIS and/or Medicare STARS quality measures.
• Strong ICD-10-CM coding knowledge and documentation requirements.
• Excellent communication and ability to provide constructive feedback to providers.

Responsibilities

• Lead HCC coding audits, identify documentation gaps, and guide risk adjustment.
• Lead quality management audits aligned with HEDIS/STARS requirements and CMS guidelines.
• Engage providers to deliver actionable feedback and drive improvements.
• Educate clinical staff on documentation and coding best practices for accurate risk adjustment.
• Track audit findings and education outcomes; report trends to leadership.
• Manage and mentor a team of 3–5 auditors; set priorities and ensure audit quality.

Skills

Leadership

Provider Education

Communication

Education

Health Information Management

Tools

EHR Systems

Chart Abstraction

Job description

Salud Healthcare is a tech-forward services organization that helps private practices transition to alternative payment models. The Sr. Manager, HCC Coding & Quality Auditor / Educator is central to that mission — helping our providers document accurately and deliver better care so the organization performs well, and stays compliant, in risk-bearing arrangements.

Position Summary

In this dual-focused role, you will lead auditing and provider education across two core areas: (1) hierarchical condition category (HCC) coding and risk adjustment, and (2) quality management. You will review patient charts to identify documentation, coding, and quality-of-care opportunities, then partner directly with providers to translate those findings into clear, actionable feedback — directly strengthening the accuracy of our risk adjustment programs and the performance of our quality measures.

Job Responsibilities

HCC Coding Audits

• Conduct prospective and retrospective audits of patient charts to identify HCC coding and risk adjustment opportunities, including under-documented or unsupported diagnoses.
• Assess documentation for ICD-10-CM coding accuracy, specificity, and support, ensuring conditions are captured to the highest appropriate level of detail.

Quality Management Audits

• Perform audits of patient charts against HEDIS and Medicare STARS measure requirements, identifying gaps in care and documentation.
• Maintain up-to-date knowledge of CMS risk adjustment guidelines, HEDIS/STARS specifications, and official coding guidelines, ensuring all audit and education activities remain compliant.

Provider Engagement & Education

• Review chart findings across both coding/risk adjustment and quality, prioritizing opportunities by impact.
• Meet with providers to convey areas of opportunity, deliver constructive feedback, and answer questions in a way that builds trust and drives sustained improvement.
• Educate providers and clinical staff on documentation and coding best practices that support accurate risk adjustment and compliant capture of chronic conditions.
• Educate providers on quality measure criteria, documentation requirements, and closing of open care gaps to improve quality performance.
• Track, document, and report audit findings and education outcomes, and collaborate with leadership on trends, recurring issues, and improvement initiatives.
• Oversee and support a team of 3–5 auditors, setting priorities, managing workload, and ensuring the accuracy and consistency of audit work.
• Coach, train, and mentor team members, building their skills in HCC coding, risk adjustment, and quality auditing.
• Provide ongoing performance feedback and professional development, fostering a collaborative and high-performing team culture.

Qualifications Required

• 2–3+ years of experience conducting provider audits and delivering provider education.
• Hands-on experience with HEDIS and/or Medicare STARS quality measures.
• Strong working knowledge of ICD-10-CM coding, including diagnosis coding specificity and documentation requirements.
• Strong communication and interpersonal skills, with the ability to deliver feedback to providers clearly, tactfully, and persuasively.

Preferred Credentials & Background

• Coding & auditing certifications, such as: CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), and/or CPMA (Certified Professional Medical Auditor).
• Familiarity with electronic health record (EHR) systems and chart abstraction workflows.
• Background in Health Information Management (HIM), or a clinical/nursing background such as an RN or LPN.
• Prior people-management experience is a plus but not required — we welcome candidates ready to grow into leading a team.

Why Salud.

We hire against five values, and they describe how we actually work. Be Bold — challenge the status quo and act with urgency, even when the path is uncertain. Be Selfless — put patients, partners, and teammates first, and share the credit. Be Authentic — bring your whole self, and give honest, candid feedback. Be Accountable — own the outcome and answer for it. Deliver Results — measure what counts, and push until the numbers actually move.

Salud Healthcare provides equal employment opportunities to all employees and applicants for employment, and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex (including pregnancy, sexual orientation, and gender identity or expression), national origin, disability status, genetic information, citizenship status, protected veteran status, marital status, or any other characteristic protected by federal, state, or local law.