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Manager, Risk Adjustment
Worcester, Massachusetts, United States
OnsiteFull Time
7+ YOEOversee risk adjustment programs, vendor management, QA, analytics, and CMS compliance for Medicare Advantage.
SQL, Power BI, Tableau, Microsoft Excel, Microsoft Word, Microsoft Outlook
1mo
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Auditor, Risk Adjustment
Arizona or New York
$83k-$109k/yr RemoteFull Time
3+ YOEBachelor's degree or equivalent; CPC; 3+ years risk adjustment coding; 1+ year RADV/QA auditing experience.
EMR systems, EDGE data environment, ICD-10 coding
2mo
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Risk Adjustment Director
Mariposa County or Merced County or Monterey County or Santa Cruz County or San Benito County or United States
$210k-$250k/yr HybridFull Time
10+ YOESenior leader with Medicare risk adjustment expertise, 10+ years in healthcare finance/analytics, strong SQL and analytics skills, Bachelor's in a related field.
SQL, Dashboarding, Reporting
2mo
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Risk Adjustment Analyst
North Palm Beach, Florida, United States
$65k-$75k/yr RemoteFull Time
2+ YOE2+ years in risk adjustment, medical coding, or primary care; strong ICD-10-CM and HCC knowledge; EHR experience; attention to detail; good communication.
Electronic Health Record (EHR) systems, ICD-10-CM, HCC coding, EHR
1mo
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Risk Adjustment Coder
Spring Valley, New York, United States
$39-$43/hr OnsiteFull Time
2+ YOE2+ years coding experience, thorough medical record review, apply ICD-10-CM and HCC guidelines, collaborate with clinicians, generate coding reports, and maintain Medicare/risk adjustment knowledge.
ICD-10-CM, HCC
2w
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Risk Adjustment Coder
Texas, United States
OnsiteFull Time
3+ YOE3+ years ICD-10 and Medicare risk adjustment coding experience; CPC/CPMA/CRC/CCS-P/CCS/RHIA/RHIT certification; associate degree; outpatient primary care and chart review experience; provider education skills.
Elation EMR
3w
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Risk Adjustment Analyst
Doral, Florida, United States
OnsiteFull Time
5+ YOEBachelor's degree required; 5+ years SQL development, 3+ years healthcare claims/risk adjustment and analytics, 2+ years Power BI, experience with Python/Scala and Databricks preferred; familiarity with CMS-HCC, HHS-HCC, HEDIS, MSSP.
SQL, Scala, Python, Microsoft Power BI, Databricks, Microsoft Excel
2mo
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Director, Risk Adjustment Products
United States
$170k-$225k/yr RemoteFull Time
10+ YOE5+ Mgmt10+ years in risk adjustment product management; 5+ years of leadership; experience with risk adjustment models, interoperability, and chart retrieval; remote-ready; strong collaboration and communication.
AWS, SQL, Core Java, Spring Boot, Web Services, XML, JSON, CI/CD
1mo
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Certified Medical Coder - Risk Adjustment
Pompano Beach, Florida, United States
$50k-$54k/yr HybridFull Time
5+ YOECPC or CSS required, 5+ years risk adjustment coding experience (in-home assessments preferred), expertise with CMS risk adjustment/HCCs, provider query management, EMR and coding tool proficiency.
ICD-10, CPT, CPT II, Electronic Medical Records (EMR), Hierarchical Condition Categories (HCCs)
2w
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Risk Adjustment Coder II
Houston, Texas, United States
OnsiteFull Time
3+ YOE3+ years commercial or Medicare risk adjustment coding experience, AHIMA/AAPC or equivalent coding credentials, ICD-10 proficiency, strong analytical and communication skills, bachelor's degree or equivalent experience.
Microsoft Word, Microsoft Excel, Microsoft Outlook, Microsoft SharePoint, Microsoft Teams
3w
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Senior Risk Adjustment Analyst
Virginia, United States
$75k-$127k/yr RemoteFull Time
5+ YOE5+ years in data analytics or software development with ≥3 years health plan experience; expertise in risk adjustment, HEDIS, CMS models; proficiency in Microsoft Excel, SAS, and SQL; bachelor’s degree required.
Microsoft Excel, SAS, SQL
1mo
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PACE Risk Adjustment Coder
Salt Lake City, Utah, United States
RemoteContract, Full Time
3+ YOE3+ years PACE risk adjustment coding experience, CRC required, extensive ICD-10-CM knowledge, EMR and Microsoft Excel/Word proficiency, strong written and verbal communication, detail-oriented and deadline-driven.
Microsoft Excel, Microsoft Word, EMR
1mo
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Sr. Risk Adjustment Auditor
Nashville or United States
$37-$43/hr RemoteFull Time
5+ YOE5+ years in risk adjustment/medical coding/CDI/auditing, CRC and CPC required, advanced ICD-10-CM/HCC/MEAT expertise, 2+ years prospective/concurrent review, EMR familiarity, ability to work remotely and travel up to 25%.
EMR, ICD-10-CM, AHA Coding Clinic, MEAT criteria, HCC
2d
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Risk Adjustment - Risk Adjustment Program Manager 135-2008
Tulsa, Oklahoma, United States
OnsiteFull Time
3+ YOEStrong knowledge of CMS HCC and HHS HCC models and RADV audits; vendor management, coding quality, retrieval, reporting, and analytics; bachelor's degree and minimum 3 years healthcare analytics/risk adjustment experience; CRC or CPC; healthcare sanctions background check.
1mo
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Manager of Risk Adjustment
United States
RemoteFull Time
5+ YOEBachelor's required; 5+ years risk adjustment/population health or value-based care experience preferred. Strong analytics, data oversight, reporting, and cross-functional influence; experience with RAF and Medicaid risk score operations.
Navina
2mo
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Risk Adjustment Analyst - Health Plan
Boise, Idaho, United States
OnsiteFull Time
6+ YOEBachelor’s degree or equivalent experience; six years of relevant experience; SQL; knowledge of QHP/ACA, Medicare Advantage risk adjustment, HEDIS/Stars preferred.
SQL, EDGE Server, Data Governance, HEDIS
1d
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Risk Adjustment Quality Specialist
Lawrence or Kansas or Missouri
HybridFull Time
3+ YOE3+ years medical coding or risk-adjustment experience with HCC knowledge; AHIMA/AAPC credentials preferred; strong analytical, documentation review, and education skills.
3M Coding Solution
2w
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Director, Prospective Risk Adjustment Operations
Baton Rouge, Louisiana, United States
OnsiteFull Time
7+ YOE7+ MgmtBachelor's required (Master's preferred),7+ years progressive leadership in risk adjustment/population health, experience with HCC coding, provider engagement, program management, strong communication and analytical skills.
3mo
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Consultant, Informatics Risk Adjustment
Saint Paul, Minnesota, United States
$64-$96/hr OnsiteFull Time
5+ YOEBachelor’s degree in health informatics or related field; 5+ years in health plan/risk adjustment; strong data analytics, clinical data knowledge; proficient with SQL and analytics tools.
SQL, Azure, Databricks, Power BI, Tableau
1w
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Risk Adjustment Manager - CoxHealth Plans
Springfield, Missouri, United States
OnsiteFull Time
5+ YOEBachelor’s in Accounting/Finance/Business, 5+ years in accounting/finance or health insurance, risk adjustment experience preferred, supervisory experience preferred, regulatory knowledge, statistical and computer skills, effective communication.
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