Risk Adjustment Jobs

The Sr. Director, Risk Adjustment Data & Analytics role is a senior leadership position within Alignment Health's data operations team, dedicated to advancing Medicare Risk Adjustment programs. The individual oversees the end-to-end data ecosystem, ensuring integrity and compliance while leading a multidisciplinary team of analysts and engineers. Key responsibilities include driving analytical insights for executive decision-making, maintaining rigorous data governance for audit readiness, and partnering with finance and clinical stakeholders to optimize revenue and care outcomes. This position appeals to candidates seeking to lead high-impact work in a mission-driven organization that prioritizes senior care. The role offers significant growth opportunities within a fast-growing company and is available in a remote work arrangement.

The Associate Director, Coding Education role leads the clinical coding curriculum strategy within the CenterWell Primary Care Organization, supporting a caring community focused on senior wellness. Key responsibilities include designing and deploying training programs for providers, aligning education strategies with organizational risk adjustment goals, and managing a team of regional coding educators. The position requires collaborating with clinical excellence and operations teams to ensure training quality and data-driven improvements. This opportunity appeals to candidates seeking to make a significant impact in value-based care while working in a collaborative, matrixed environment. The role offers hybrid flexibility with limited regional travel and the chance to mentor a distributed team of professionals.

The Director of Program Delivery role leads risk management and quality audit strategies within Humana's Risk Adjustment department. The position focuses on overseeing regulatory audits to ensure accurate data submission to federal agencies, driving operational excellence in coding quality, and developing analytics to minimize organizational risk. Key responsibilities include managing team goals and budgets, establishing compliance programs, and collaborating with cross-functional partners to enhance process improvement. This leadership opportunity appeals to professionals seeking to make a significant impact in healthcare while fostering a positive culture. The role is primarily remote with occasional travel required for meetings and training, offering a flexible work arrangement supported by a dedicated home office setup.

The Medical Coding Educator 2 role supports the Medicare Risk Adjustment team by enhancing provider documentation and coding quality. Key responsibilities include arranging educational sessions for providers, analyzing coding audit data to identify error patterns, and creating data-driven presentations on compliance trends. The position requires collaboration with cross-functional teams to improve workflow processes and may involve occasional travel to provider offices. This opportunity appeals to candidates seeking to make a direct impact on healthcare outcomes within a caring community. The role offers a remote work arrangement with flexibility, supported by a company dedicated to putting health first and providing comprehensive wellness benefits.

The Inpatient Coding Manager role leads the coding department within a top-ranked non-profit health system, reporting to the Director of Revenue Integrity. Key responsibilities include managing daily operations of coding teams, developing department policies and training materials, and ensuring compliance with federal regulations and accurate billing practices. The position also involves educating providers on documentation standards and collaborating with clinical quality teams to capture outcomes data. This opportunity appeals to professionals seeking to drive revenue integrity in a community-focused environment with a reputation for excellence. The role is based on-site in Fayetteville, Arkansas, within a standard office setting.

The Medicaid & ACA Manager role supports the strategic and operational execution of Medicaid and Affordable Care Act programs within a trusted Kansas-based healthcare organization. Key responsibilities include building detailed workplans, monitoring performance indicators like medical loss ratios and enrollment trends, and leading cross-functional coordination to ensure regulatory compliance and financial objectives are met. The position appeals to candidates seeking a dynamic environment with a strong emphasis on family, professional growth through training programs, and a collaborative culture that values inclusivity. This full-time position offers flexible work arrangements, including remote, hybrid, or onsite options, for individuals residing in or willing to relocate to Kansas or Missouri.

This management role within the Health Information Management department oversees Clinical Documentation Integrity and education across the Hartford HealthCare system. The position involves leading a team of specialists to manage audits, prevent revenue denials, and ensure regulatory compliance with Medicare and coding standards. Key responsibilities include developing staff education programs, analyzing performance metrics, and collaborating with revenue cycle leadership to improve data quality and patient safety reporting. The role appeals to experienced nursing professionals seeking career growth within a comprehensive healthcare network that values innovation and work-life balance. The position requires travel between facilities and offers the opportunity to influence system-wide clinical documentation strategies.

The Senior Quality Specialist role at Tapestry 360 Health focuses on driving quality improvement and value-based care initiatives within a mission-driven Federally Qualified Health Center. Key responsibilities include analyzing clinical performance data to close care gaps, coordinating population health outreach programs, and developing standardized workflows to enhance operational efficiency. The position requires close collaboration with clinical and administrative teams to translate metrics into actionable strategies that improve patient outcomes. This opportunity appeals to professionals seeking to make a tangible community impact while working in a supportive environment that offers comprehensive benefits, including retirement plans and eligibility for Public Service Loan Forgiveness. The role is based in a professional office setting with occasional travel for meetings and community events.

The HRP Consultant role functions as a strategic functional lead bridging healthcare payor and provider domains. The position involves defining end-to-end business workflows, translating complex requirements into functional specifications, and providing thought leadership on industry trends like value-based care and interoperability. Key responsibilities include advising on transformation roadmaps, ensuring regulatory compliance, and collaborating with technology teams to deliver scalable solutions. This opportunity appeals to professionals seeking to drive significant business transformation within a dynamic healthcare environment. The role offers a chance to work on high-impact modernization programs while leveraging deep expertise in claims, revenue cycle, and clinical operations.

This senior Data Architect role focuses on designing and maintaining enterprise-scale data architectures specifically for Medicaid claims, eligibility, and care management within the healthcare sector. The position involves establishing data ingestion frameworks, defining governance standards to ensure HIPAA and CMS compliance, and leading cloud-based modernization efforts using platforms like Snowflake or Azure. Key responsibilities include translating complex regulatory requirements into scalable technical solutions, mentoring data engineering teams, and ensuring data quality across high-volume pipelines. The role is appealing for its opportunity to shape critical healthcare infrastructure while working in a fully remote environment with a collaborative culture that values professional growth and technical leadership.

The Business Information Security Officer role serves as a strategic liaison within the Information Security organization at LexisNexis Legal & Professional, bridging the gap between security protocols and business innovation. The position focuses on embedding security-by-design principles into the product lifecycle, translating complex risk data into actionable insights for product and executive leaders, and fostering collaboration across cross-functional teams. This opportunity appeals to professionals from diverse backgrounds, including product, strategy, or operations, who excel at relationship-building and influencing decision-making. The role offers significant career growth through mentorship and training in core security concepts, supported by a culture that prioritizes work-life balance, flexible scheduling, and comprehensive wellbeing initiatives.

The Plant Operator role within Archaea Energy's Gas & Low Carbon Energy team focuses on the safe and efficient operation of landfill gas-to-energy facilities. Key responsibilities include executing control of work processes, performing maintenance and troubleshooting on engine generator sets, and monitoring plant performance to mitigate operational risks. The position offers the appeal of contributing to sustainable energy solutions within a safety-first culture that emphasizes professional growth and team collaboration. This full-time, on-site position requires availability for rotating shifts and involves up to 25% travel.

This General Liability Claims Consultant role within The Hartford Global Specialty Claims Division handles complex bodily injury and property damage claims from inception to resolution. Key responsibilities include conducting investigations, making coverage determinations, managing litigation and counsel, and setting financial reserves for high-value cases. The position appeals to professionals seeking a mission-driven environment where they can shape the future of insurance while developing strategic resolution skills. The role offers a flexible hybrid or remote work arrangement, with in-office expectations varying by location, and provides opportunities to contribute to broader enterprise goals and product development initiatives.

This senior underwriting role involves leading the establishment of a new Allied Healthcare division within an international insurance company. The position focuses on assessing and pricing professional liability coverage for diverse medical entities, including surgical centers, hospices, and physician groups. Key responsibilities include managing the underwriting team through hiring and coaching, developing the business book, and collaborating directly with executive leadership. The role offers a significant growth opportunity within a stable organization that prioritizes long-term employee development. While based in New Britain, Connecticut, remote work arrangements may be available, and the position emphasizes a collaborative culture with comprehensive benefits.

This senior underwriting role involves leading the establishment of a new Allied Healthcare division within an international insurance company based in Peoria, Illinois. The position focuses on assessing and pricing professional liability coverage for diverse medical entities, including surgery centers, hospices, and physician groups. Key responsibilities include developing the business book, managing the underwriting team through hiring and coaching, and collaborating directly with executive leadership. The role offers significant growth potential as the primary leader in a newly formed program. It provides remote work flexibility and emphasizes a long-term culture with opportunities for professional development and team building.

This Principal Engineer role in Technical Operations focuses on leading process development and continuous improvement within radiopharmaceutical manufacturing. The position involves managing Non-Conformance Reports, Corrective and Preventive Actions, and Change Controls to ensure strict adherence to ISO 13485 and 21 CFR 820 regulations. Key responsibilities include creating Master Batch Records, serving as a Subject Matter Expert for cross-functional teams, and driving data analysis to enhance operational efficiency and product quality. The role offers the opportunity to work on complex, high-impact projects that directly support patient care through innovative technical solutions. It is designed for experienced engineers who thrive in a collaborative environment where they can mentor colleagues and independently solve difficult process challenges.

This full-time, one-to-two-year associate role supports InterVarsity's undergraduate ministry across the Greater North Texas area, serving as a training ground for future Campus Staff Ministers. The position involves teaching Scripture, leading student spiritual growth, providing pastoral care, and managing administrative and fundraising tasks. Key responsibilities include mentoring student leaders, developing ministry strategies, and cultivating relationships with ministry partners to support the organization's mission. The role appeals to those seeking intensive ministerial training within a collaborative team environment. It offers a flexible work schedule, comprehensive benefits including health and retirement plans, and professional development opportunities. The position is based in Texas and focuses on fostering spiritual transformation and community engagement on university campuses.

The Referral Coordinator role serves as the primary point of contact for participants, guiding them through triage, assessment, and onboarding into health and wellbeing interventions. Key responsibilities include managing multi-channel referrals, conducting compassionate needs assessments, facilitating access to virtual care platforms, and ensuring accurate data capture while adhering to safeguarding protocols. The position appeals to candidates passionate about supporting vulnerable individuals through behavior change, offering a mission-driven environment focused on improving community health outcomes. The role requires flexible availability, including evenings and weekends, to ensure service accessibility for all residents.

The Referral Coordinator role serves as the primary point of contact for participants, guiding them through triage, assessment, and onboarding into health and wellbeing interventions. Key responsibilities include processing multi-channel referrals, conducting compassionate needs assessments, managing caseloads via case management systems, and facilitating access to virtual care platforms. The position requires accurate data capture, adherence to safeguarding protocols, and the delivery of brief interventions based on behavior change principles. This opportunity appeals to those passionate about improving community health, offering a supportive environment focused on diversity and inclusion. The role involves flexible working arrangements, including evenings and weekends, to ensure service availability for all residents.

The Referral Coordinator role serves as the primary point of contact for participants, guiding them through triage, assessment, and care pathway selection within a health and social care environment. Key responsibilities include processing multi-channel referrals, conducting compassionate needs assessments, managing caseloads via case management systems, and encouraging engagement with virtual care platforms. The position requires accurate data capture, adherence to safeguarding protocols, and the delivery of brief interventions aligned with government guidelines. This opportunity appeals to individuals passionate about supporting vulnerable populations through behavior change, offering a collaborative culture focused on continuous professional development and flexible working arrangements to accommodate diverse community needs.

The Referral Coordinator role serves as the primary point of contact for participants, guiding them through the triage and assessment process with compassion and professionalism. Key responsibilities include managing multi-channel referrals, conducting needs assessments, facilitating onboarding to virtual care platforms, and ensuring accurate data capture while adhering to safeguarding and privacy standards. The position appeals to those passionate about health and social care by offering the opportunity to support vulnerable individuals through meaningful behavior change journeys. The role requires flexible working hours, including evenings and weekends, to ensure service availability for all residents, and operates within a collaborative team environment focused on continuous improvement and high-quality service delivery.

The Referral Coordinator role serves as the primary point of contact for participants, guiding them through triage, assessment, and care pathway selection within a health and social care environment. Key responsibilities include processing multi-channel referrals, conducting compassionate needs assessments, managing caseloads via case management systems, and encouraging engagement with virtual care platforms. The position requires accurate data capture, adherence to safeguarding protocols, and the application of behavior change principles to support vulnerable individuals. This opportunity is appealing for those passionate about improving community health outcomes, offering a collaborative culture focused on continuous professional development and flexible working arrangements to accommodate diverse participant schedules.

The Referral Coordinator role serves as the primary point of contact for participants, guiding them through triage, assessment, and care pathway selection within a health and social care environment. Key responsibilities include processing multi-channel referrals, conducting compassionate needs assessments, managing caseloads via case management systems, and encouraging engagement with virtual care platforms. The position requires accurate data capture, adherence to safeguarding protocols, and the application of behavior change principles to support vulnerable individuals. This opportunity appeals to those seeking a mission-driven role focused on improving community health outcomes, offering a collaborative team culture with flexible working arrangements including evenings and weekends to ensure service accessibility.

The Referral Coordinator role serves as the primary point of contact for participants, guiding them through triage, assessment, and care pathway selection within a health and social care environment. Key responsibilities include processing multi-channel referrals, conducting compassionate needs assessments, managing caseloads via case management systems, and encouraging engagement with virtual care platforms. The position requires accurate data capture, adherence to safeguarding protocols, and the application of behavior change principles to support vulnerable individuals. This opportunity appeals to those seeking a mission-driven position focused on improving community health outcomes, offering a collaborative team culture with flexible working arrangements including evenings and weekends to ensure service accessibility.

The Referral Coordinator role serves as the primary point of contact for participants, guiding them through a compassionate triage and assessment process to access appropriate health interventions. Key responsibilities include managing multi-channel referrals, conducting needs assessments, facilitating onboarding to virtual care platforms, and maintaining accurate data records while adhering to safeguarding protocols. The position appeals to candidates passionate about supporting vulnerable individuals through behavior change, offering a collaborative environment focused on improving community health outcomes. The role requires flexibility to work evenings and weekends to ensure service availability, with opportunities for continuous professional development within a diverse and inclusive team.