Vice President, Clinical Informatics

Remote Opportunity

About Reveleer
Reveleer 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, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.

POSITION SUMMARY

The Vice President of Clinical Informatics is a senior executive leader responsible for defining, operationalizing, and scaling Reveleer’s clinical informatics strategy across its payer–provider platform. This role ensures that complex clinical, claims, and provider data are translated into actionable intelligence that drives measurable outcomes in risk adjustment, quality improvement, provider engagement, and regulatory compliance.
This leader plays a critical role in unifying and advancing clinical informatics capabilities across Reveleer’s Prospective Intelligence portfolio, including MD Portals, Curation, Novillus, and related solutions, while partnering closely with Product, Engineering, Operations, Sales, and Client Success.

KEY RESPONSIBILITIES

• Own and evolve Reveleer’s enterprise clinical informatics strategy aligned to business, product, and market priorities.

• Serve as the authority on clinical data interpretation, quality measures, risk adjustment methodologies, and clinical defensibility.

• Establish and govern standards for clinical logic, measure specifications, coding methodologies, and evidence models across all CI solutions.

• Partner with Product and Engineering to translate clinical requirements into scalable, production-ready platform capabilities.

• Ensure consistent clinical definitions, shared data assets, and interoperable workflows across the Prospective Intelligence portfolio.

• Support strategic client engagements and serve as a senior clinical leader in discussions with health plan and provider executives.

• Oversee clinical data quality, validation, governance, and audit readiness.

• Build, lead, and mentor a high-performing clinical informatics organization.

• Act as an internal and external thought leader, positioning Reveleer as a trusted authority in prospective intelligence.

QUALIFICATIONS & EXPERIENCE

• Advanced clinical degree required (NP, PA, PharmD, or equivalent).

• 10+ years of experience in clinical informatics, healthcare analytics, or health technology, including 5+ years in senior leadership roles.

• Deep expertise in risk adjustment, HEDIS/Stars, clinical coding, and payer–provider workflows.

• Demonstrated experience working with health plans and large provider organizations.

• Strong understanding of healthcare data standards, interoperability, and EHR-enabled workflows.

• Proven ability to operate effectively in a fast-growing, integration-focused environment.

• Solid understanding of EMR systems and associated workflows: Epic, Athena, Cerner etc.

LEADERSHIP ATTRIBUTES

• Strategic and operational leader with a bias toward execution.

• Credible clinical voice capable of influencing product, technology, and business leaders.

• Results-driven, data-oriented, and accountable for outcomes.

• Collaborative, decisive, and resilient in complex environments.

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.

Reveleer E-Verifies all new hires.

Reveleer 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.

Senior Actuary, Health Plan Analytics

Remote Opportunity

About Reveleer

Reveleer 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, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.

About the role

Reveleer is hiring a senior actuary to lead health plan and risk adjustment analytics for each line of business for Reveleer customers across Medicare Advantage (MA), Medicare Advantage Prescription Drug (MAPD), Affordable Care Act (ACA), Medicaid, and provider value-based contracts. This role builds member-level actuarial models that quantify risk adjustment performance, HCC (Hierarchical Condition Category) capture, medical economics, utilization, and population health trends, and translates those models into customer-facing dashboards that inform pricing, forecasting, and program strategy.

This actuary works directly with customer success, analytics, product, operations, and clinical teams to convert raw claims, encounter, member, provider, and clinical data into decision-ready outputs. The role requires both technical model-building skill and the ability to explain actuarial and risk adjustment concepts to non-actuarial stakeholders, including provider and health plan executives.

What you will do

• Build and maintain member-level actuarial models covering risk adjustment (RAF) performance, HCC capture and recapture, medical economics, utilization patterns, and population health metrics across MA, MAPD, ACA, and Medicaid populations.

• Develop analytics that can support rate-setting for Medicare Advantage Bids, ACA rate filings, Medicaid capitation arrangements, and value-based contract terms.

• Reconcile RAF calculations against source files, including the Monthly Membership Report (MMR), Model Output Report (MOR), MAO-004, and the Beneficiary-Level file, and extend that reconciliation logic into customer-facing reporting.

• Design the actuarial and analytic logic behind customer-facing dashboards, partnering with data engineering and product teams to translate member-level models into usable, accurate, and timely visualizations.

• Produce forecasting and accrual models that support midyear and final settlement estimates, transfer payments, capital planning, and financial reporting for risk adjustment programs.

• Analyze utilization trends, medical loss ratio (MLR) drivers, and cost-of-care patterns to identify actionable opportunities for customers managing value-based contracts.

• Support MA and HHS RADV (Risk Adjustment Data Validation) readiness by modeling audit exposure and prioritizing chart review and coding efforts based on financial impact.

• Communicate model methodology, assumptions, and results clearly to actuarial and non-actuarial audiences, including customer executives.

• Partner with clinical, coding, retrieval, and provider engagement teams to align analytic outputs with chronic HCC recapture, care gap closure, and quality initiatives.

What you bring

Required qualifications

• Seven or more years of actuarial or actuarial-adjacent analytics experience in health plan pricing, risk adjustment, or medical economics.

• Direct pricing or performance modeling experience across at least three of the following: Medicare Advantage, MAPD, ACA, Medicaid, and value-based contracts.

• Working knowledge of the CMS-HCC and ACA risk model, RAF score calculation, and the relationship between ICD-10 diagnosis coding and risk adjustment revenue.

• Demonstrated experience building member-level data models that feed reporting or dashboard tools, such as Tableau or Power BI.

• Proficiency in SQL and at least one statistical or scripting language, such as SAS, R, or Python.

• Proficiency in utilizing AI tools to support modeling

• Bachelor's degree in actuarial science, mathematics, statistics, economics, or a related quantitative field.

• Strong written and verbal communication skills, with experience presenting actuarial findings to executive audiences.

Preferred qualifications

• Associate of the Society of Actuaries (ASA) designation or Fellowship (FSA) or progress toward.

• Experience with CMS files, including the MMR, MOR, MAO-004, and Beneficiary-Level file.

• Experience with EDPS & EDGE encounter submissions and encounter data quality processes.

• Prior experience supporting RADV & IVA audit readiness or chart review prioritization.

• Familiarity with provider incentive program design tied to chronic HCC recapture or quality performance.

• Experience with financial forecasting, including ACA transfer payments and MA settlement accruals

Tools and technical skills

SAS (Enterprise Guide), SQL, Tableau, Microsoft Excel, R and RStudio, Python, Microsoft Access, and Microsoft Visual Basic (VBA) are all relevant to this role. Reveleer does not require proficiency in every tool listed; candidates should be strong in at least three of these and comfortable learning the rest on the job.

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.

Reveleer E-Verifies all new hires.

Reveleer 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.

Customer Success Manager - Healthcare Risk Adjustment

Remote Opportunity

About Reveleer

Reveleer 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, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.

Position Summary:

As a Customer Success Manager, Healthcare Risk Adjustment, you will play a key role in driving customer goals, business transformation, and revenue expansion by ensuring the engagement, success, and growth of Reveleer’s customers across your assigned book of business. The Customer Success Manager will ensure Reveleer customers successfully adopt the platform with a positive experience, driving growth for Reveleer through renewals and expansion.

Essential Functions:

• The Customer Success Manager, Risk Adjustment will work to build long-term, strategic, executive-level partnerships with high-revenue, high level of complexity customers specifically within the ACA HHS CMS RADV Initial Validation Audit.

• You will work across your assigned book of business to understand your customer’s value drivers, business goals, workflows, organizational structures, and requirements.

• As the primary point of contact, you will work to ensure the customer’s successful adoption of the Reveleer platform technology while simultaneously ensuring successful project outcomes through cross-functional collaboration with Operations, Product, Analytics and Engineering teams.

• Engage with customers daily - through scheduled meetings, emails, ad-hoc calls as requested.

• Proactive daily knowledge of customer’s reporting and alignment to service level agreements and ability to share gap closing plans.

• Indepth knowledge of CMS Regulatory requirements for solutions provided by Reveleer.

• You will work closely with senior leadership to identify, track and drive resolution for critical project issues, ensuring escalations are clearly defined, prioritized, and managed closely to produce results that align with the customer’s business needs.

• Develop a deep understanding of Reveleer’s platform and service offerings to offer consultative support, share best practices, drive expansion, and promote retention.

• Utilize Gainsight to create success plans, monitor customer health and document progress towards defined program goals and milestones.

• Participates in departmental and organizational meetings regularly to communicate major milestones, conduct business reviews, create executive summaries and other communication methods as required to present across internal audiences including senior leadership and C-Suite.

Competencies:

• Caring – Warm, sincere, calm, cool and collected energy and presence with the ability to develop relationships.

• Results Driven – Focus on achievement, motivated by results and outcomes, goal oriented.

• Analytical – Can look at data and determine any changes in trending or key performance indicators that could identify risk.

• Effectively Communicates – Speaks clearly, listens effectively, and responds well to questions; Writes clearly and informatively; Edits work for errors; Varies writing style to meet needs; Able to read and interpret information; Documents are accurate and delivered on time; Uses good judgement when communicating information.

• Problem Solver - Expertise managing client relationships and accounts for technically complex products and platforms with the ability to lead a resolution towards mutual success.

• Continuous Quality Improvement – Evaluates polices, programs, and services; Implements strategies for continuous quality improvement; Assesses the use of evaluation findings for improving policies, programs, and services; Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.

• Customer Focus - Follows through; Courteous; Helps internal and external customers; Understands customer perspectives and needs; Assesses the effects of decisions on different customers and services; Develops and maintains partnerships that will increase customer satisfaction and decrease risk

• Interpersonal Skills - Builds strong relationships; Flexible and open minded; Receptive to feedback; Motivates employees and peers for the purpose of achieving organizational goals.

• Professionalism – Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.

• Adaptability – Adapts to changes in the work environment; Adjusts methods to best fit the situation; Able to deal with change, delays, or unexpected events. Can work with diverse groups of customers and internal stakeholders.

• Cultural Sensitivity – Models behaviors that reflect the culture of Reveleer; Awareness of the similarities and differences that exist between employees, teams, departments and customers to build more effective relationships.

Required Education and Experience:

• Bachelor’s Degree preferred or equivalent work experience required.

• 5+ years' experience working within a Health Plan and/or experience in a customer-facing vendor management role , managing Risk Adjustment/specific to RADV lines of business, or other relevant healthcare experience.

• Minimum two years’ experience working in account management within HHS RADV Initial Validation Audit.

• Significant experience in presenting detailed reports, gap closing plans and project plan dependencies to Sr Level Customer contacts.

• Strong Project Management skills with demonstrated ability to manage and track multiple customer requests, issues and project plans.

• Self-motivated, team player with exceptional organizational, presentation and communication skills, both written and verbal.

• Track record of performing in agile, Saas based environments with high levels of professionalism and interpersonal savvy in high-stress situations.

• Proficiency with MS Office, advanced proficiency in Excel.

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.

Reveleer E-Verifies all new hires.

Reveleer 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.

CUSTOMER TRAINING SPECIALIST

Remote Opportunity

About Reveleer

Reveleer 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, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.

Position Overview

The Customer Training Specialist delivers comprehensive, customer-focused training on the Reveleer platform across clinical coding, data retrieval, and analytics features. This role is responsible for designing and delivering live virtual and in-person training sessions that enable customers to effectively use Reveleer's end-to-end platform functionality. The Customer Training Specialist works closely with the Onboarding team, Learning and Development, Operations, and Product to ensure training materials are current, scalable, and aligned with customer needs and platform updates.

Key Responsibilities

Customer Training & Program Delivery

• Facilitate live virtual training sessions for customers across clinical coding, data retrieval, and analytics platform features, ranging from one-on-one coaching to group sessions. Occasional in-person training may be required based on customer needs.

• Assessing customer-level training needs based on project requirements, onboarding status, and performance data

• Deliver interactive, role-specific training tailored to customer team structures and workflows

• Provide one-on-one and small-group coaching to customers on platform functionality, coding standards, and retrieval processes

• Train customers on how to access, interpret, and use Reveleer's analytics and reporting features within the platform

Content Development & Collaboration

• Partner with Learning and Development to develop customer training materials, including facilitator guides, job aids, quick-reference tools, and knowledge assessments

• Work with Product and operational teams to ensure training materials reflect current platform capabilities and processes

• Identify gaps in existing training resources and recommend updates based on customer feedback and performance trends

• Contribute to the development and refinement of training lesson plans and learning objectives

Continuous Improvement & Support

• Gather feedback from training sessions and use performance data to refine training content and delivery methods

• Review customer audit results and performance trends to identify re-education needs and coaching opportunities

• Maintain current knowledge of clinical coding guidelines, retrieval workflows, and platform functionality

• Support customers beyond initial onboarding with ongoing learning assistance and skill development

Cross-Functional Collaboration

• Liaise with Onboarding, Customer Success, and Operations teams to understand customer training needs

• Coordinate with Product teams on platform updates and how they impact customer training

• Work with Quality and Retrieval teams to ensure training aligns with compliance standards and operational expectations

• Participate in special projects and training initiatives as needed

Required Qualifications

Clinical Coding Expertise

• Current or recent clinical coding certification: CPC (AAPC), RHIT, or equivalent healthcare coding certification

• Minimum 3-5 years of hands-on clinical coding experience

• Strong knowledge of ICD-10 and CPT coding guidelines, medical terminology, anatomy, and physiology

• Understanding of coding audit processes and quality improvement methodologies

• Familiarity with risk adjustment and quality coding in a healthcare operations environment

Training & Communication Skills

• Demonstrated ability to facilitate engaging, interactive training sessions in live virtual and in-person formats

• Strong presentation and public speaking skills; comfortable delivering training on camera and in virtual settings

• Excellent verbal and written communication skills; ability to explain complex clinical and technical concepts clearly and concisely

• Experience developing or contributing to training materials such as guides, job aids, and reference documents

• Ability to adapt communication style and instructional approach to meet diverse learner needs

• Experience gathering and incorporating feedback to improve training quality and outcomes

• Strong listening and coaching skills; ability to build rapport with learners and support skill development

Technical & Platform Skills

• Proficient in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook)

• Strong computer skills with ability to learn new systems and platforms quickly

• Comfortable with virtual training tools (Zoom, Microsoft Teams, LMS platforms)

• Ability to navigate and understand platform-based workflows and reporting features

Professional Competencies

• Detail-oriented with strong analytical skills; ability to review data and identify trends

• Self-directed and highly organized; able to manage multiple training initiatives with minimal supervision

• Collaborative approach; able to work effectively with cross-functional teams and diverse stakeholders

• Professional demeanor; tactful communication and ability to work with customers and internal teams

• Adaptability; able to adjust to changing priorities, new platform features, and evolving customer needs

• Strong commitment to confidentiality and HIPAA compliance when handling customer and patient information

Preferred Qualifications

• Experience in customer-facing training or customer success roles

• Familiarity with Learning Management Systems (LMS) or training delivery platforms

• Experience in healthcare operations, clinical coding departments, or quality improvement initiatives

• Knowledge of adult learning principles and instructional design best practices

• Experience creating knowledge checks or assessments to measure learning outcomes

WHAT YOU’LL RECEIVE:

• Competitive salary 

• Medical, Dental and Vision benefits 

• 401k with Employer 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.

Reveleer E-Verifies all new hires.

Reveleer 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.

Vice President of Operations- Clinical Intelligence

Remote Opportunity

About Reveleer
Reveleer 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, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.

Why This Role Matters

Clinical Intelligence is a complex; multi-product business built through acquisition and growth. Long-term success depends on disciplined operations, predictable delivery, and strong execution fundamentals.

The VP of Operations is critical to turning strategy into results and ensuring the Clinical Intelligence organization operates as a cohesive, high-performing unit.

Role Summary

The Vice President of Operations (VP Ops) for Clinical Intelligence is the senior operating executive and day-to-day execution leader for the Clinical Intelligence business unit. This role is designed specifically as the GM’s operational and trusted second-in-command, with full accountability for translating strategy into disciplined execution across people, process, and delivery.

This role is intentionally structured for a developing operator with deep institutional knowledge of Reveleer’s Clinical Intelligence domain and technology stack. Will work with GM to establish operating cadence, cross-functional execution, and delivery rigor, allowing the GM to focus on enterprise leadership, strategic growth, key customers, and internal (Reveleer) and external (customer) stakeholders.

Core Objectives (What Success Looks Like)

· Partner with GM to establish and run a predictable, scalable operating model across the Clinical Intelligence portfolio

· Coordinate consistent execution partnership across Product, Engineering, Delivery, and Operations

· Drive accountability, clarity, and operational discipline across CI teams

· Partner with finance to develop and maintain key operating metrics to measure and monitor performance

· Improve delivery efficiency, predictability, and gross margin performance

· Ensure understanding of ROI and evolution of ROI of all customers consuming solutions from this suite

· Manage a consistent, repeatable and efficient model on how we access data from the exchanges and how we reciprocate data

Key Responsibilities

1. Operating Cadence & Execution Leadership

· Own the day-to-day operating rhythm of the Clinical Intelligence business

· Lead weekly execution reviews, operational dashboards, and KPI tracking

· Ensure priorities are clearly defined, resourced, and delivered on time

· Translate GM priorities into executable plans with clear owners and milestones

2. Delivery, Operations & Process Ownership

· Own CI delivery operations across customers and products

· Standardize processes across MD Portals, Curation, CGMA, and CLEAN

· Identify and eliminate operational bottlenecks, rework, and inefficiencies

· Ensure operational readiness for new clients, expansions, and product launches

3. Cross-Functional Integration

· Serve as the execution bridge between Product, Engineering, Sales, and Operations

· Partner closely with Product to ensure roadmap feasibility and delivery readiness

· Align Sales commitments with operational and delivery realities

· Drive tighter handoffs across pre-sale, implementation, and ongoing delivery

4. Financial & Performance Management

· Support GM to:

o Improve delivery economics and gross margin

o Work with GM to track operational KPIs tied to ARR, cost-to-serve, and utilization

o Support pricing discipline through operational cost transparency

o Deliver on all financial commitment for the segment

· Ensure operational data is accurate, timely, and decision-ready

5. Strategic Initiative Execution

· Own execution of high-priority CI initiatives including:

o Operating model unification across acquisitions

o Tooling, automation, and workflow improvements

o EMR / EHR integration execution support

o Client remediation and stabilization efforts

6. People, Leadership & Culture

· Lead CI operations and delivery leaders with clear expectations and accountability

· Reinforce a culture of ownership, follow-through, and continuous improvement

· Identify skill gaps, capacity constraints, and organizational risks

· Support talent development and succession within CI operations

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.

Reveleer E-Verifies all new hires.

Reveleer 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.

Customer Success Manager
Remote

About Reveleer

Reveleer 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, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.

Key Responsibilities:

• Build and maintain strong customer relationships, serving as the primary point of contact across the full lifecycle from onboarding through renewals.

• Lead day-to-day project management, including planning, progress tracking, customer meetings, and issue resolution.

• Proactively identify and mitigate customer risks, driving solutions in collaboration with internal teams.

• Receive, document, and triage customer-reported issues; assess priority based on business impact and urgency and ensure alignment with internal capacity.

• Coordinate cross-functionally with Product, Engineering, Data, and Analytics to ensure customer issues are routed, tracked, and resolved in line with roadmap and sprint priorities.

• Communicate transparently with customers on issue status, timelines, and workarounds, managing expectations effectively.

• Track and document customer requests and recurring issues, contributing to knowledge base development and continuous process improvement.

• Analyze customer data to identify adoption trends, risks, and growth opportunities, providing actionable insights to both customers and internal stakeholders.

• Conduct regular check-ins, business reviews, and renewal discussions to drive customer satisfaction, retention, and expansion.

• Serve as a trusted advisor, guiding customers on best practices and ensuring measurable value realization from the platform.

• Escalate critical issues and advocate for customer needs internally, influencing product roadmap and service delivery.

• Own and grow enterprise-level customer relationships, aligning Reveleer’s solutions with customer business goals.

Qualifications:

• Bachelor’s degree in a related field or equivalent experience; Advanced Degrees are preferred

• At least 5 years of experience in consulting, project management, or customer management for a technology solution

• Knowledge and demonstrated understanding of Risk Adjustment models and data validation requirements

• Demonstrated leadership capabilities and high performance in previous positions

• Demonstrated ability to prioritize tasks and work effectively across departments to resolve challenges

• Proficiency with project management and CRM tools (e.g., Jira, HubSpot, Gong) or similar platforms.

• Healthcare experience required, preferably with a provider, payer, or intermediary organization

• Ability to work autonomously but seek assistance proactively

• Strong oral and written communication skills, comfortable presenting to internal and external stakeholders

• Strong problem-solving skills with the demonstrated ability to identify research and make recommendations and/or decisions

WHAT YOU’LL RECEIVE:

• Competitive salary 

• Medical, Dental and Vision benefits 

• 401k with Employer 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.

Reveleer E-Verifies all new hires.

Reveleer 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.

Clinical Coding Manager

Remote

About Reveleer
Reveleer 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, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.

We are seeking a full time Clinical Coding Manager to oversee duties of Risk Adjustment and reporting.

What You'll Do:

• Oversee and/or perform an accurate medical record review for all RISK
• Support and participate in process and quality improvement initiatives
• Conduct training related to ,RISK, platform usage, up date any training materials, and function as RISK SME
• Monitor project status
• Work on flexible projects with variable client/project specific guidelines
• Review all Negative / Positive hits
• Manage RISK coding projects when needed- including project status and completing chart reviews for coding projects as needed.

Job Requirements:

• Must have a professional coding certificate through AHIMA/AAPC
• Minimum of 5 years of hands-on medical records experience
• 5 Years of RISK and IVA experience
• 3+ years of management experience
• Background in UR, QA and/or QI experience preferred
• Strong computer skills and high-speed internet access at home
• Commitment to confidentiality of patient health information
• Professional, articulate and able to work independently
• Ability to manage teams and meet deadlines
• Be able to conduct trainings in nonstandard time frames to meet abstractor needs and training
• Clinical Documentation Review: Analyze medical records and NLP results and validate that the clinical evidence meets the necessary requirements for submission and documentation. This includes making sure the documentation accurately reflects the patient’s conditions, treatment and services provided. Identify gaps, inconsistencies, and discrepancies in documentation that could impact patient care, quality reporting and reimbursement.
• Coding Support: Ensure documentation aligns with accurate code assignment and follow CMS’s coding guidelines for HCC risk adjustment coding.
• Clinical Knowledge: Maintain a deep understanding of medical terminology, disease processes, treatments, and procedures to accurately interpret and validate clinical documentation.
• Documentation Integrity: Safeguard the integrity and confidentiality of patient health information while handling medical records and sensitive data in accordance with HIPAA and other relevant regulations.
• Interdisciplinary Communication: Foster clear communication and collaboration between different healthcare departments, ensuring that accurate patient information is shared across the continuum.

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.

Reveleer E-Verifies all new hires.

Reveleer 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.