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- JOB SUMMARY: Responsible for overseeing the day-to-day execution, performance, and optimization of the risk adjustment program across vendor management, medical record retrieval, coding quality, analytics, reporting, and audit readiness. This role drives process improvement...Risk
- UnitedHealth Group's Optum NY in New York, NY seeks an Executive Director of Risk Adjustment to lead enterprise-wide risk capture programs across networks, ensuring compliant and sustainable RAF performance that affects financial results. The role partners with provider...Risk
- Massadvantage in Worcester, MA is seeking a Manager of Risk Management to oversee Medicare risk adjustment activities. This role involves driving strategies, ensuring compliance, and interacting with vendors and providers. Ideal candidates will have at least 7 years in...Risk
- ...Reviewing medical records and validating diagnosis information, the full-time Risk Adjustment Coding Specialist will work remotely to ensure accurate risk adjustment coding while adhering to established guidelines and departmental procedures. Key Responsibilities Review...RiskFull timeRemote work
Virtual Vocations Inc
United States2 days ago - ...Job Description: This professional position is assigned the responsibility and accountability to manage and coordinate the risk adjustment programs for Cox HealthPlans (CHP). This manager will work with other staff and leaders within CHP to ensure risk-adjusted...RiskShift workDay shift
CoxHealth
Springfield, MO3 days ago - Optum in New York, NY seeks an Executive Director of Risk Adjustment to lead enterprise risk adjustment programs across Optum East and embed risk capture into clinical workflows. This leadership role focuses on accurate RAF performance, regulatory compliance, and cross-...Risk
- ...Blue Cross Blue Shield of Nebraska is seeking a Healthcare Analytics professional to analyze healthcare data for Risk Adjustment programs, evaluate performance, and drive actionable insights for intervention planning and decision‑making. The role supports reporting, forecasts...RiskRemote work
BlueCross BlueShield of Nebraska
Saint Paul, MN4 days ago - Vytwo in Dallas, TX seeks a Risk Adjustment Coding Auditor for a 6-month engagement to support CMS RADV audit passes. The role requires a CPC and CRC certification and 5+ years of risk adjustment experience, with proficiency in MS Office. The team will run first and second...Risk
- A healthcare technology firm is seeking a Senior Product Manager to lead the strategy and execution of a risk adjustment product. The ideal candidate should have 5-7 years of experience in product management within healthcare, a strong understanding of Value-Based Care,...RiskRemote job
- ...Risk Adjustment Coding Specialist We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Houston market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends...Risk
- ...Risk Adjustment Coding Specialist We are currently seeking a highly motivated Risk Adjustment Coding Specialist. This role will report to a Sr. Manager - Risk Adjustment and enable us to continue to scale in the healthcare industry. The staff is required to frequently...Risk
- ...Supporting the Risk Adjustment team in a fully remote capacity, the Specialist, Risk Adjustment will manage daily operations related to medical record retrieval and provider outreach while ensuring compliance with CMS and HHS deadlines. Key responsibilities: Support daily...RiskWork experience placementRemote work
Virtual Vocations Inc
United States21 hours ago - UASI is seeking a Risk Adjustment Clinical Documentation Specialist to support coding accuracy and HCC capture in a fully remote capacity. The role emphasizes clinical judgment, analytical skills, and a commitment to documentation integrity reflecting patient severity and...RiskRemote job
- ...will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage questions in real time, research correct coding guidelines,...Risk
$31.03 - $36.03 per hour
...degree, an additional 2 years of relevant work experience is required in addition to the required work experience. ~3 years of risk adjustment and/or hierarchical condition category coding experience. ~ Strong knowledge of diagnosis code validation, coding...RiskTemporary workWork experience placementRemote workCynet Systems
United States21 hours ago$100k - $231.54k
...is seeking a Lead Director, Informatics (Performance Reporting & Insights) to lead the development and delivery of enterprise risk adjustment analytics and business intelligence solutions. This role transforms complex clinical, operational, and risk adjustment data into...RiskHourly payFull timeTemporary workWork experience placementLocal areaCVS Health
Remote29 days ago- Oscar Health is hiring an Associate, Risk Adjustment Auditor for their Risk Adjustment team. This remote role requires conducting quality audits specific to ICD-10 code abstraction and ensuring compliance with coding standards. The ideal candidate holds a Bachelor's degree...RiskRemote job
- ...range reflects the Northern CA region. Lower salary ranges will apply for other labor markets outside of NCAL.Support Health Plan Risk Adjustment strategy through data analysis, performance monitoring, and business insights that drive operational excellence, compliance...Risk
- Greater Good Health in El Segundo, CA, is seeking a Risk Adjustment Coding Specialist to own retrospective CDI chart reviews, strengthen coding compliance, and optimize risk capture for our Medicare-focused care model. You will collaborate with Revenue Cycle, Clinical Operations...Risk
- Mount Sinai Medical Center of Florida, Inc. is seeking a Certified Risk Adjustment Coder to ensure accurate coding and documentation standards. The role involves reviewing medical records, providing feedback to physicians, and maintaining coding credentials. The ideal candidate...Risk
- County of Contra Costa is seeking one (1) Workers' Compensation Claims Adjuster II to join the Risk Management team. The role involves self-administered claims and benefits for industrial injuries within the County, reporting to a Senior Adjuster or Supervisor, with a...Risk
- Molina Healthcare is seeking an analyst to support enterprise risk adjustment predictive analytics. The role designs and develops suspect, targeting, and tracking systems to support Molina’s prospective and retrospective interventions. The position involves QA reporting...Risk
- Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support risk adjustment efforts across provider practices. The role involves chart reviews to identify coding gaps, delivering education to providers, and tracking KPIs such as HCC recapture and AWVs...RiskRemote job
- A public agency in California is seeking a Workers' Compensation Claims Adjuster II to join the Risk Management team. This role involves investigating claims, administering benefits, and working closely with legal counsel. The County values a diverse workforce and offers...RiskRemote job
- UASI is actively seeking a Clinical Risk Adjustment Documentation Specialist to support accurate outpatient CDI and HCC coding in a fully remote capacity. You'll collaborate with physicians and care teams to ensure documentation quality and regulatory compliance while optimizing...RiskRemote job
- Oscar Health is hiring a remote Associate, Risk Adjustment Auditor to join their Risk Adjustment team. This role involves conducting internal and external quality audits specific to ICD-10 code accuracy. The ideal candidate will have experience in risk adjustment coding...RiskRemote job
- ...range reflects the Northern CA region. Lower salary ranges will apply for other labor markets outside of NCAL.Support Health Plan Risk Adjustment operations through government audit readiness, compliance oversight, and internal quality assurance reviews. Perform coding...RiskWork experience placement
- ...Risk Adjustment Specialist Location: Birmingham, Alabama Job Summary The Risk Adjustment Specialist ensures all ICD-10 codes are documented for the assignment of valid and accurate HCCs for each record reviewed for submission to the Centers for Medicare & Medicaid...RiskImmediate startFlexible hours
Bham-Corporate Office
Birmingham, AL2 days ago - Cambia Health Solutions is hiring a Risk Adjustment Campaign Associate for a hybrid role with 3 days in the office. The position supports Medicare Advantage and Commercial risk adjustment campaigns, coordinating with the Risk Adjustment operations team and cross-functional...RiskWork at office
- Astrana Health seeks a Risk Adjustment Coding Specialist II to support the Houston market. You will review medical records to identify coding gaps, deliver education to providers, and track KPI metrics to improve program outcomes. The role requires AAPC CPC/CRC certifications...RiskRemote job
