Clinical Operations Lead

Clinical Operations Lead Remote Opportunity About

delivers a unified platform spanning risk adjustment, quality improvement, clinical intelligence, and member management for health plans and provider organizations navigating the complexity of value-based care. Trusted by 80+ customer organizations nationwide, the platform integrates data, analytics, and intelligent workflow automation into one governed system designed to support traceable documentation across diagnoses, quality measures, and submissions. With regulatory expertise and transparent, human-in-the-loop AI at its core, supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.

What You’ll Do: •Assisting Managers with clinical pends •Assisting with over-read feedback •Assigning manual assignments

• Assisting with individual data entry production (MRR or OR1)
• Reviewing reports daily for QA scores during the season(s) (abstractors, coders, HPs)
• Ensure collaboration among cross functional teams for the roll out of product releases
• Additional duties as necessary to meet the obligations to our clients

About You:

• Current Coding Certification (CPC, CPC-P, CPC-H, CPC-I, CRC, CCS, RHIT, RHIA etc.) through AAPC and/or AHIMA
• Minimum of 5 years coding experience with specific knowledge of Medicare and Commercial Risk Adjustment such as Hierarchical Condition category (HCC)
• Additional experience in facility (OPPS/IPPS) coding experience is preferred
• Additional experience in Health Plan Risk Adjustment Data Validation Audit (RADV) experience is preferred
• Excellent verbal and written communication skills, including the ability to effectively communicate with internal and external customers

Experience and Skills:

• Ability to work independently in a fast-paced remote environment with minimal supervision and guidance
• Ability to interact with management and remote coding personnel
• Possess strong organizational skills and attention to detail
• Ability to adapt to changing priorities while managing a wide range of projects
• Adaptive and flexible to new ideas and change
• Advanced knowledge of medical terminology, anatomy and pharmacology
• Advanced skills utilizing official coding resources for research and problem solving
• Advanced skills and knowledge of computers, use of required software to perform job functions
• Excellent written and communication skills and the ability to explain complex information

WHAT YOU’LL RECEIVE: •Competitive salary  •Medical, Dental and Vision benefits  •401k match •Generous PTO plan 

Our compensation reflects the cost of labor across several US geographic markets. Pay is based on several factors including market location and may vary depending on job-related knowledge, skills, and experience.

E-Verifies all new hires.

is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity, sexual orientation, age, marital status, veteran status, disability status or genetic information, in compliance with applicable federal, state and local law.