33 risk adjustment consultant jobs at 14 companies in United States
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Risk Adjustment Consulting, Experienced
Oakland or California
$37-$56/hr HybridFull Time
3+ YOECollege degree or equivalent experience, 3 years of healthcare experience, risk adjustment knowledge, AI tools, prompt engineering, workflow automation, dashboard development, and strong communication skills.
Python, SQL
2mo
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Workers Compensation Risk Consultant
Ontario or California
$100k-$120k/yr RemoteFull Time
2+ YOE2+ years risk management/claims adjusting experience; obtain state risk management license (Property & Casualty Agent, Risk Manager, or Adjuster); strong administrative skills, client communication, and Microsoft Office proficiency.
Microsoft Outlook, Microsoft Excel, Microsoft Word, Microsoft PowerPoint
19h
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Strategy Consultant - Risk Adjustment Accuracy
Pennsylvania or Maryland or Washington or North Carolina or Louisiana or Kentucky or Kansas or Indiana or Illinois or Georgia or Iowa or Florida or Colorado or Delaware or Connecticut or Arkansas or Arizona or Alabama or Alaska or Nevada or Vermont or Tennessee or Idaho or Oklahoma or Hawaii or Mississippi or Utah or New Hampshire or New Mexico or Wyoming or North Dakota or South Dakota or Rhode Island or West Virginia or Missouri or Texas or District of Columbia or Ohio or New Jersey or Oregon or South Carolina or Virginia or Massachusetts or Nebraska or Minnesota or Michigan or Wisconsin or New York or Maine
$109k-$181k/yr HybridFull Time
6+ YOEMaster's degree in business, healthcare, economics, or related field; 2 years of post-graduate strategy consulting experience and 6 years of related business or healthcare experience, or bachelor's substitution.
Microsoft Office, Microsoft PowerPoint, Microsoft Excel
1mo
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Compliance Consultant IV - Medical Coding - Risk Adjustment
Pasadena or California or Oregon or Washington or Colorado or Georgia or Virginia or Hawaii or Maryland or District of Columbia
$107k-$138k/yr RemoteFull Time
4+ YOE4+ years medical coding experience, 6+ years related healthcare/compliance experience or degree substitution; certification in risk adjustment or coding required; advanced knowledge of coding, documentation, and audit methods.
2d
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RISK MANAGER
Santa Fe, New Mexico, United States
$39-$57/hr OnsiteFull Time
Performs management, administrative, and supervisory duties for the City's Risk Management Office, including loss prevention, insurance procurement, contract review, claims adjustment, consultation, and liability financial management.
1mo
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Clinical Consultant Specialist CDI
Louisville, Kentucky, United States
OnsiteFull Time
4+ YOERegistered nurse with extensive CDI and acute care experience, strong knowledge of ICD-10/DRG/CMS, risk adjustment and value-based care, auditing, education, and Microsoft Office proficiency.
Microsoft Office, Microsoft Excel, Microsoft PowerPoint, Microsoft Word
2mo
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Ambulatory Audit Consultant
Michigan or United States
$96k-$132k/yr RemoteFull Time
8+ YOEExpertise in professional/ambulatory coding (ICD-10-CM, CPT/HCPCS), E/M level assignment, Medicare billing, risk adjustment, clinical documentation integrity, coding audits, and educating customers; certifications and 8+ years' experience required.
EMR, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
2mo
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IPA Consultative Coder
North Las Vegas, Nevada, United States
$59k-$81k/yr HybridFull Time
3+ YOE3+ years risk-adjustment medical coding experience; CCS, CRC or CPC certification; familiarity with value-based care; must live within 50 miles of assigned market; consultative and audit experience.
4d
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Product Manager
United States
$103k-$128k/yr RemoteFull Time
3+ YOEBachelor's degree in a quantitative or related field, 3+ years in healthcare product management, analytics, consulting, or technology, including 2+ years developing risk adjustment products; interoperability expertise required.
CMS-HCC, HHS-HCC, EHR, EMR, AI/ML
2mo
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Business Development Executive (MedInsight)
Seattle or Atlanta or Appleton or Boise or Wakefield or South Burlington or Chicago or Dallas or Windsor or Houston or Indianapolis or Little Falls Township or Pasadena or Brookfield or Eden Prairie or Omaha or Irvine or Berwyn or Phoenix or Portland or Portland or San Diego or San Francisco or St. Louis or Salt Lake City or Tampa or Walnut Creek
$105k-$199k/yr RemoteFull Time
8+ YOE8+ years enterprise new-business development in consultative sales, experience selling to health plans/providers, knowledge of risk adjustment and reimbursement landscape, strong executive selling and territory planning skills.
Salesforce
2mo
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Customer Success Manager
United States
$100k-$110k/yr RemoteFull Time
5+ YOEBachelor's degree or equivalent, 5+ years in consulting/project management/customer management for a technology solution, healthcare experience required, knowledge of risk adjustment, proficiency with Jira/HubSpot/Gong, strong communication and leadership.
Jira, HubSpot, Gong
2mo
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CMS EDGE Server Product Manager / Principal / Architect
Chicago, Illinois, United States
RemoteFull Time, Contract
7+ YOE7+ years healthcare payer experience with deep CMS EDGE Server and ACA Risk Adjustment knowledge; experience with membership/claims/encounter data, implementation and client-facing consulting, strong communication and stakeholder management.
CMS EDGE Server, Facets (TriZetto), ClaimSphere, Cognizant CMS EDGE Server, SQL
1mo
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Director - Payer Sales
United States
$200k/yr RemoteFull Time
10+ YOE10+ years healthcare SaaS sales with significant experience selling to payers/health plans, proven C-suite consultative selling, familiarity with risk adjustment and quality programs, executive negotiation and multi-million quota ownership.
Slack, Google Suite, Notion, Figma, Epic Payer Platform
2mo
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Director: Payer Strategy & Program Design
Washington, District of Columbia, United States
RemoteFull Time
7+ YOE7+ years of relevant experience including in-house Medicare Advantage health plan experience; deep MA knowledge (STARS, risk adjustment, performance management); client-facing consulting, project leadership, mentoring, and strong communication skills.
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