Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. The individual will provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for daily operations pertaining to auditing functions as assigned. The individual will provide superior customer experience by educating internally and externally on opportunities for improvement discovered during auditing. This individual will work closely with Management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. You will:
- Maintain a quality assurance program
- Play a key role in ensuring coding compliance and accuracy
- Monitor the performance of the Risk Adjustment Operations both internally and with coding vendors
- Provides expertise as it relates to coding compliance for new and existing services, while ensuring compliance with organizational, federal, state, and third-party requirements.
- Assist in the methods to effectively communicate information through presentations, reports, educational programs, memoranda, etc. by providing formal and informal education to QA specialists, coding vendors and staff.
- Report findings to Leadership in a timely, consistent and effective manner ensuring that appropriate changes are implemented.
- Support audit processes ensuring work flows and results are properly documented and maintained. Identify process improvements as needed.
- Assist in the development of an effective training program regarding correct coding techniques/practices
- Assist with training new auditors and training of other staff as needed.
- Create methods to share information on the program, quality, and initiatives with Management on a monthly cadence at minimum.
- Perform other duties as assigned
What you will bring to the table:
- Bachelor's degree in relevant field of study preferred or 3-5 years related work experience coder with a minimum of 5 year's coding experience in risk adjustment both ACA and MA.
- Expert knowledge of Risk Adjustment .
- Research and problem resolution skills.
- Exceptional interpersonal relationship skills.
- Must possess strong managerial, financial, and analytical skills.
- Consistent demonstration of commitment to quality, customer focus, productivity, and process improvement.
- Strong communication skills to effectively interact all levels of the organization, business unit leaders, and staff in a tactful and positive manner.
- Experience overseeing remote (Work at Home) operations.
- Exceptional interpersonal skills, proven success in complex and ambiguous environments.
- Ability to work independently, with high productivity, and regularly meet deadlines.
- Demonstrates excellent written and verbal communication skills conforming to all rules of punctuation, grammar, diction and professional style.
- Experience in initiating, developing and monitoring policies, internal control procedures and operating standards.
We are committed to building a diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.
At Datavant our total rewards strategy powers a high-growth, high-performance, health technology company that rewards our employees for transforming health care through creating industry-defining data logistics products and services.
The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific job. The estimated total cash compensation range for this role is:
$78,000
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$92,000 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.
This job is not eligible for employment sponsorship.
Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay.
At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way.
Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please contact us atpeopleteam@datavant.com. We will review your request for reasonable accommodation on a case-by-case basis.
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Datavant
Jun 03, 2025