Senior Director of Risk Adjustment
Virtual Vocations Inc
Providing executive leadership for risk adjustment performance, the full-time Senior Director of Risk Adjustment will manage cross-functional initiatives to enhance coding accuracy, documentation quality, and provider performance while working remotely. Key responsibilities: Serve as the primary liaison between Enterprise Risk Adjustment and market leadership to drive alignment and execution of strategic priorities Lead market risk adjustment strategies to achieve enterprise performance objectives across various lines of business Establish and monitor performance targets related to risk score capture and coding accuracy Required qualifications: Bachelor's Degree in Business Administration, Healthcare Administration, Finance, Analytics, Public Health, or related field; Master's Degree preferred 8+ years of experience in healthcare operations, risk adjustment, or related healthcare field 3+ years of management experience in complex cross-functional initiatives 5+ years of experience presenting operational performance and strategic recommendations to executive leadership Demonstrated expertise in risk adjustment operations and healthcare analytics
- Optum NY in New York, NY seeks an Executive Director of Risk Adjustment to lead enterprise-wide risk adjustment programs across the organization. You will drive strategy for Medicare Advantage, Medicaid, and Commercial contracts, and align risk capture with clinical workflows...Senior
- ...Senior Director Health Actuarial RoleSpecialist in a carrier actuarial function. Closer to a carrier specialist role than capital strategy: the remit is a defined ACA risk adjustment function rather than enterprise capital, ERM, or ORSA.Senior Director health actuarial...SeniorRemote work
$147.55k - $215.18k
...Hi, we're Oscar. We're hiring a Senior Manager, Actuarial - Risk Adjustment to join our Actuarial team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to...SeniorFull timeRemote workWork from homeHome office$196.73k - $286.9k
...Hi, we're Oscar. We're hiring a Senior Director, Actuarial - Risk Adjustment to join our Actuarial team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012...SeniorFull timeRemote workWork from homeHome office- Astrana Health seeks a Sr. Director of Risk Adjustment to lead risk adjustment, clinical documentation improvement, provider engagement, and population health strategies. This leader will guide Senior Managers, Managers, and teams, translating enterprise priorities into...SeniorRemote work
- Astrana Health, Inc. is seeking a Sr. Director - Risk Adjustment to lead the Risk Adjustment organization from our Alhambra office. You will build structure, standardize processes, develop leaders, and drive accountability across a multi-market operation. The role requires...SeniorWork at office
$127k - $160k
...healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.Job SummaryThe Senior Manager, Risk Adjustment Operations and Performance Improvement leads the operational and analytics-informed execution of Medicare Advantage...SeniorWork at officeRemote work$160k - $195k
...Sr. Director - Risk Adjustment Department: Quality - Risk Adjustment Employment Type: Full Time Location: 1668 S. Garfield Ave. 2nd Floor... ...role will lead multiple layers of leadership, including Senior Managers, Managers, and their teams, while translating enterprise...SeniorFull timeContract workRemote work$150k - $206.3k
...a part of our caring community The Director, Risk Management identifies and analyzes potential... ...position. The Director of Risk Adjustment Regulatory Audits will be responsible for... ...regulators Experience in presenting senior leadership Work at Home Requirements...Full timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome office$134.6k - $230.8k
...Improve the lives of others while Caring. Connecting. Growing together. Job Description - Executive Director of Risk Adjustment (2381661) Executive Director of Risk Adjustment - 2381661 Optum NY, is seeking an Executive Director of Risk Adjustment join our team...Minimum wageFull timeWork experience placementLocal areaWork from homeMonday to Friday- ...Humana Inc. is seeking a Director, Risk Adjustment Regulatory Audits to strategize and drive execution of external risk adjustment regulatory audits. The role emphasizes strong operational processes, cross-functional leadership, and partnering with regulatory bodies to...Remote work
- ...Humana Inc. is seeking a Director of Risk Adjustment Regulatory Audits to develop strategy and execute external audits, ensuring strong operational processes and cross-functional collaboration. The role involves leveraging technology to improve audit workflows and communicating...Remote work
- ...Humana Inc. is seeking a Director, Risk Management focused on external risk adjustment regulatory audits. This remote role reports to the Associate VP, Risk Adjustment Compliance and requires leading audits, developing strategy, and cross-functional coordination to improve...Remote work
- ...Description Job Description JOB DESCRIPTION JOB TITLE: Sr. Manager, Risk Adjustment FLSA STATUS: Exempt DEPARTMENT: Quality Improvement and Risk Adjustment REPORTS TO: Sr. Director, Quality Improvement, Risk Adjustment, and Health Analytics AUTHORITY:...SeniorWork at officeShift work
- ...Humana Inc. is seeking a Director, Risk Adjustment Regulatory Audits to lead the strategy and execution of external risk adjustment audits.... ...collaboration with the risk adjustment compliance team and senior leadership to drive efficiency and outcomes. #J-18808-LjbffrRemote work
- ...Position Title: Senior Risk Manager (On-Site Position) Location: Granville , OH Pay Range: N/A Application Instructions... ..., and coordination with carriers, third-party administrators, adjusters, and outside counsel. # Assist with claims and litigation management...SeniorContract workFor subcontractorWork at officeLocal area
$128k - $173k
...millions of consumers. Responsibilities JOB PURPOSEThe Senior Manager, Investment and Risk Management plays a pivotal role in strengthening the... ...AccountabilitiesInvestment & Risk EvaluationAssess risk‑adjusted returns, key assumptions, and downside exposures across...SeniorFull timeTemporary workWork experience placement- Mosaic Health is seeking a Regional Director of Burden of Illness Operations to lead BOI initiatives across physician practices, guiding risk adjustment programs and documentation improvement. You will translate CMS-HCC methodologies into scalable workflows, collaborating...
- This OpportunityWSP is seeking a Senior Risk Manager to join our Project Controls group in Houston, TX.Your ImpactAct as the risk management... ...strategic decision making.Advise project leadership on risk adjusted contingency and schedule reserve ranges based on quantitative...SeniorContract workLocal areaFlexible hours
$121.2k - $163.9k
...doorstep.We are seeking a bold, data-driven Sr. Risk Manager to lead the programmatic... ...Visibility: You'll communicate directly with senior leadership, influence enforcement policy... ...and need a workplace accommodation or adjustment during the application and hiring process...SeniorWork at officeFlexible hoursDay shift- Location: Florida, New York, United StatesCompany: ADPPosted: 2026-10-07ADP, Inc. in New York is seeking a Senior Risk Adjustment Coder to drive accurate, compliant risk adjustment coding through retrospective audits, chart reviews, and provider education. The role partners...Senior
$96.9k
...a business-centric way while addressing risk. Typical transactions will range from standard... ...candidate will support and report to a Senior Risk Manager and be enthusiastic about... ...ManagementPrefer prior Program ManagementClaims adjusters license or law license · Work with...SeniorFor contractorsWork at officeWorldwideFlexible hours$160k - $220k
...a leading US Healthcare Actuarial Consulting firm seeking a Senior Actuarial Manager within Medicare & Value-Based Care to support... ..., and ACOs on Medicare financial strategy, shared savings, risk adjustment, and total cost of care. This role would suit an experienced...SeniorWork at officeRemote work$194.1k - $242.6k
...As Marqeta's Senior Director, Credit Risk , you will lead our underwriting team and be responsible for developing and designing strategy to help... ...modeling and data science Proactively monitor and adjust Marqeta's credit policies based on performance and risk trends...SeniorWork at officeRemote workFlexible hours$157.3k - $262.7k
## Director, Risk AdjustmentApply: California-Remote: Full time: Posted 2 Days Ago: JR100164Come Grow With Us At Gold Coast Health Plan,... ...Job Function & Responsibilities**• Develop and execute a risk adjustment strategy aligned to organization goals, regulatory requirements...Full timeRemote work- Job Title: Senior Director, Head of Engineering - Operational RiskRole Summary: The Director, Head of Engineering - Operational Risk will be a member of the Engineering Practice and aligned to the Risk & Compliance Hub. This role is responsible for engineering strategy,...SeniorWorldwideFlexible hours
- ...where we have a legal entity. Responsibilities The Risk and Compliance Senior Manager at Atlassian will play a key role in driving the... ...the best experience, we can support with accommodations or adjustments at any stage of the recruitment process. Simply inform...SeniorWork at officeLocal area
$200k - $300k
...investment objective is to provide investors consistent and attractive risk-adjusted returns with low correlation to global capital markets by... ...an internally managed central trading layer portfolio. The Senior Equity Risk Manager will be joining the Central Trading and...SeniorTemporary workWorldwide- ...Fannie Mae in Reston, VA seeks a Senior Director, Cybersecurity Risk Oversight Lead to advance the CRCD's independent oversight strategy and serve as a senior second line of defense leader overseeing governance, risk identification, appetite, issue management, and executive...Senior
- ...in mind. We are looking for a Manager of Risk Managment to oversee Mass Advantages's full suite of Risk Adjustment activities. This position is responsible for the... ...assessment of Medicare revenue initiatives for senior products; leading and coordinating enterprise risk...Work at office
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