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Vice President Hcc Risk Adjustment Coder Jobs in Nevada

Goldenent

Vice President, Security

Laughlin, NV · On-site

Summary: As the Vice President of Security, you are entrusted with the overall strategic and ... Develop and implement internal controls, risk mitigation strategies, and compliance monitoring ...

Seminolehardrock

VP, Culinary Operations

Las Vegas, NV

$59K - $76K/yr

... codes. * Complete consistent and high-quality food presentation, constantly striving to improve ... Communicate with relevant leadership team regarding issues, risk and liability concerns, or other ...

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Vice President Hcc Risk Adjustment Coder information

What is a Vice President HCC Risk Adjustment Coder?

A Vice President HCC (Hierarchical Condition Category) Risk Adjustment Coder is a senior executive responsible for overseeing the medical coding operations related to risk adjustment in healthcare organizations. They lead teams that ensure accurate coding of patient diagnoses and health information, which impacts how healthcare providers are reimbursed by insurance payers, especially Medicare Advantage plans. Their role typically involves compliance oversight, quality assurance, training coders, and strategic planning to optimize risk scores. These professionals require extensive experience in medical coding, deep knowledge of HCC models, and strong leadership skills. They play a critical part in helping organizations maximize compliant reimbursement and improve patient outcomes.

What are the key skills and qualifications needed to thrive as a Vice President HCC Risk Adjustment Coder?

To thrive as a Vice President HCC Risk Adjustment Coder, you need deep expertise in HCC coding, risk adjustment methodologies, healthcare regulations, and a relevant certification such as CPC, CRC, or CCS. Mastery of coding software, EHR systems, and data analytics platforms is typically required. Leadership, strategic thinking, attention to detail, and strong communication skills distinguish top performers in this role. These skills are crucial for ensuring coding accuracy, regulatory compliance, and driving organizational success in value-based care environments.

What are some common challenges faced by a Vice President HCC Risk Adjustment Coder, and how can they be managed?

A Vice President HCC Risk Adjustment Coder often faces the challenge of ensuring coding accuracy and compliance across large teams while keeping up with evolving CMS guidelines. Managing remote or distributed coding staff, integrating new technology solutions, and balancing productivity with quality assurance are also common hurdles. Success in this role requires strong communication skills, ongoing coder education, and the implementation of robust audit processes to maintain data integrity and regulatory compliance.

What is the difference between Vice President Hcc Risk Adjustment Coder vs Hcc Risk Adjustment Coder?

AspectVice President Hcc Risk Adjustment CoderHcc Risk Adjustment Coder
CredentialsAdvanced certifications, leadership experienceCertifications like CPC, CCS, or RHIT
Work EnvironmentExecutive-level, strategic planningOperational, coding departments
Industry UsageUsed in large healthcare organizations, insurersCommon in hospitals, clinics, coding firms

The Vice President Hcc Risk Adjustment Coder focuses on strategic leadership and oversight of risk adjustment coding programs, often requiring advanced certifications and leadership skills. In contrast, the Hcc Risk Adjustment Coder handles day-to-day coding tasks, ensuring accurate HCC coding based on medical records. Both roles are vital in healthcare risk management but differ mainly in scope, responsibilities, and experience level.

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Vice President Hcc Risk Adjustment Coder jobs near you

Vice President II, Payments Systems Technology

Credit One Bank

Las Vegas, NV

Full-time

Re-posted 20 days ago

Job description

Position Summary 

The Vice President, Payments Systems Technology is responsible for the strategy, architecture, delivery, and operational management of the Bank's enterprise payment platforms. This leader will oversee the technology ecosystem supporting ACH, Debit Card Processing, Payment Account Verification, Payment Rules and Orchestration, Real-Time Payments (RTP), FedNow, Wire Payments, and related payment services.

The VP will partner closely with business, operations, product, risk, fraud, compliance, security, and vendor teams to deliver secure, scalable, highly available payment solutions that enhance customer experience, support business growth, and meet regulatory requirements. This role will lead to the modernization of payment capabilities and ensure operational excellence across all payment systems.

Payments Technology Leadership
  • Define and execute the Bank's payments technology strategy and multi-year roadmap.
  • Lead the design, development, implementation, and support of enterprise payment platforms.
  • Drive modernization initiatives leveraging APIs, cloud technologies, automation, and event-driven architectures.
  • Partner with business leaders to align technology investments with strategic objectives.
  • Evaluate emerging payment technologies and industry trends to enhance the Bank's payment capabilities.
Payment Platform Ownership

Provide technology leadership and oversight for:

  • ACH processing including Same Day ACH, returns, exceptions, and NACHA compliance.
  • Debit Card authorization, transaction processing, routing, and network integrations.
  • Payment Account Verification and account ownership validation solutions.
  • Payment Rules Engines and transaction decisioning platforms.
  • Payment orchestration, routing, exception handling, and workflow automation.
  • Real-Time Payments (RTP), FedNow, Wire Transfers, and other payment rails.
Operational Excellence & Risk Management
  • Ensure 24x7 availability, reliability, performance, and resiliency of payment systems.
  • Establish monitoring, observability, disaster recovery, and business continuity capabilities.
  • Lead production support, incident management, and root cause analysis efforts.
  • Ensure compliance with NACHA, PCI-DSS, FFIEC guidance, banking regulations, and internal security standards.
  • Partner with Risk, Fraud, and Information Security teams to strengthen fraud prevention and payment controls.
Vendor & Team Leadership
  • Manage strategic relationships with payment processors, technology vendors, and service providers.
  • Lead vendor selection, contract negotiations, and performance management.
  • Build, develop, and mentor high-performing teams of managers, architects, engineers, and support professionals.
  • Manage budgets, resource planning, and technology investments.
Required Qualifications
  • Bachelor's degree in Computer Science, Information Systems, Engineering, or related field. Advanced degree preferred.
  • 12+ years of technology experience with at least 7 years leading payment technology organizations within banking, financial services, fintech, or payment processing environments.
  • Proven success delivering and operating large-scale, mission-critical payment platforms.
  • Experience leading cross-functional teams and managing strategic technology initiatives.
Required Payments Expertise

Deep experience with:

  • ACH Processing and NACHA Rules
  • Debit Card Processing
  • Payment Account Verification Services
  • Payment Rules and Orchestration Platforms
  • Real-Time Payments (RTP)
  • FedNow
  • Wire Payments
  • Fraud Detection and Payment Risk Controls
  • Payment Exceptions and Reconciliation
  • Core Banking and Digital Banking Integrations
Technical Qualifications
  • Enterprise payments architecture and distributed systems design.
  • API and microservices-based application development.
  • Cloud platforms (AWS preferred).
  • DevSecOps, CI/CD, and modern software engineering practices.
  • High-availability, disaster recovery, and resiliency architectures.
  • Containerization, Kubernetes, and modern integration technologies.
  • Cybersecurity, encryption, and identity management practices.
Leadership Competencies
  • Strategic and innovative thinker.
  • Strong executive communication and stakeholder management skills.
  • Proven ability to lead large-scale transformation initiatives.
  • Results-oriented with a focus on operational excellence and customer experience.
  • Strong risk management, governance, and vendor management capabilities.
Success Measures

Success in this role will be measured by:

  • Payment platform availability, reliability, and performance.
  • Successful delivery of payment modernization initiatives.
  • Regulatory and audit compliance outcomes.
  • Reduction in production incidents and operational risk.
  • Improvement in payment processing efficiency and customer experience.
  • Effective leadership, talent development, and organizational performance.

Credit One Bank, N.A. is a data-driven financial services company based in Las Vegas. Founded in 1984, Credit One Bank offers a spectrum of credit card products for people in all stages of financial life. Credit One Bank is an equal opportunity employer committed to diversity and inclusion and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation, or national origin. Reasonable accommodations can be made for those who require them, including access to job applications and workplace accommodations. Employment at Credit One Bank is based on mutual consent (also known as at-will). This means that employees and the Bank may terminate the employment relationship at any time, with or without cause and with or without notice. Please contact the recruiter for this position to learn more. Credit One Bank does not accept unsolicited resumes from agencies and is not responsible for related fees.