Associate Director

Role & responsibilities

• Lead end-to-end HCC medical coding operations, ensuring quality, productivity, accuracy, and turnaround time (TAT) targets.
• Manage large-scale coding teams, including managers, team leaders, auditors, and coders.
• Oversee risk adjustment coding for Medicare Advantage and other applicable US healthcare programs.
• Ensure compliance with CMS guidelines, ICD-10-CM coding standards, and applicable risk adjustment regulations.
• Drive coding accuracy, audit performance, risk adjustment validation, and continuous improvement initiatives.
• Monitor operational KPIs, SLAs, productivity, quality metrics, and financial performance.
• Lead client interactions, business reviews, escalations, and strategic stakeholder engagements.
• Develop operational strategies for capacity planning, resource optimization, training, and performance management.
• Collaborate with quality, training, compliance, and technology teams to improve coding efficiency.
• Drive automation, process standardization, and operational transformation initiatives.

Required Skills & Qualifications

• 15-20+ years of experience in US Healthcare RCM, with significant expertise in HCC / Risk Adjustment coding.
• Proven experience leading large-scale medical coding operations at a senior leadership level.
• Strong knowledge of ICD-10-CM, CMS guidelines, Medicare Advantage, and risk adjustment methodologies.
• Experience managing multiple delivery teams and operational managers.
• Strong understanding of coding quality audits, compliance, productivity, and performance metrics.
• Excellent client management, communication, stakeholder management, and problem-solving skills.
• Experience in process improvement, operational transformation, and technology-enabled coding solutions.
• Relevant coding certifications such as CPC, CRC, CCS, or equivalent are preferred.

Preferred Candidate Profile

• Experience as Senior Manager, Director, or Associate Director in a US Healthcare RCM organization.
• Demonstrated success in managing high-volume HCC coding delivery operations.
• Strong business acumen, people leadership, and client-facing capabilities.
• Ability to drive operational excellence while maintaining coding accuracy and regulatory compliance.

Key Focus Areas: HCC Risk Adjustment | US Healthcare RCM | Medicare Advantage | ICD-10-CM | Large-Scale Team Management | Client Delivery | Quality & Compliance