Chanda Caffey-Moore

WORK HISTORY

EDUCATION

ABOUT CHANDA CAFFEY-MOORE

Strategic healthcare executive with a proven record of advancing accuracy, compliance, and financial integrity across Medicare Advantage, Medicaid, and ACA risk adjustment programs. I’ve led enterprise initiatives that strengthened provider engagement, optimized HCC coding, and built scalable compliance frameworks aligned with CMS and RADV standards.In my current role with ASK Consulting, I partner with national payer organizations to evaluate audit integrity, enhance documentation precision, and translate complex analytics into actionable quality improvements. My approach blends data-driven strategy, audit expertise, and education to ensure performance excellence across every phase of the risk adjustment lifecycle.Previously, as Director of Risk Adjustment Education and Coding Compliance at Elevance Health, I led multi-state initiatives leveraging NLP analytics and cross-functional collaboration to deliver measurable gains in coding accuracy, quality outcomes, and provider transparency. I’m passionate about AI-enabled audit solutions, integrated data ecosystems, and leadership cultures that elevate healthcare integrity and accountabilitySr. Consultant & Risk Adjustment Coding AnalystASK Consulting | Jul 2025 – PresentSupport risk adjustment operations through coding accuracy review, data validation, and provider documentation analysis. Collaborate with compliance and analytics teams to ensure accurate HCC capture and submission integrity across Medicare Advantage and Medicaid lines.Medical Records Supervisor & HIPAA Privacy OfficerPublic Health – Dayton & Montgomery County (PHDMC)| Dec 2024 – Jun 2025Directed daily medical records operations for ROI, HEDIS, and RADV audits. Led HIPAA compliance, staff training, and privacy investigations, ensuring full regulatory adherence and audit readiness.Director, Risk Adjustment Education, Coding Compliance & Quality InitiativesElevance Health | Jun 2014 – Sep 2024Led risk adjustment strategy and provider education across 20+ states for Medicare and Medicaid lines. Improved risk score accuracy by 37% through NLP analytics, coding audits, and enterprise-wide compliance programs.Interim Staff Vice President, Risk AdjustmentAnthem (Elevance Health)| Jun 2022 – Apr 2023Directed provider performance and audit recovery initiatives, achieving a 53% improvement in diagnosis recapture and $60K+ vendor compliance recovery. Developed risk adjustment programs supporting value-based care. Delivered provider training on ICD-10, HCC coding, and documentation compliance.