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Assistant Risk Adjustment Auditor Jobs in Chicago, IL

JBT MAREL CORPORATION

Internal Auditor

Chicago, IL · On-site

$90 - $110/hr

You will help complete risk assessments to establish the annual internal audit plan, preparing ... JBT Marel will reasonably accommodate applicants who need adjustments to participate in the ...

JBT Marel Corporation

Internal Auditor

Chicago, IL · On-site +1

$90K - $110K/yr

You will help complete risk assessments to establish the annual internal audit plan, preparing ... JBT Marel will reasonably accommodate applicants who need adjustments to participate in the ...

JBT Marel Corporation

Internal Auditor

Chicago, IL · Remote

$90K - $110K/yr

You will help complete risk assessments to establish the annual internal audit plan, preparing ... JBT Marel will reasonably accommodate applicants who need adjustments to participate in the ...

The Heico Companies

Internal Auditor

Warrenville, IL · On-site

$68K - $75K/yr

Analyze data to understand trends and risk patterns and recommend adjustments to the audit ... approach. * Assist Internal Audit management in identifying internal control and financial ...

RB Global Inc.

Internal Auditor

Westchester, IL · On-site

$70 - $95/hr

Foundational understanding of internal control frameworks (e.g., COSO) and risk management ... timely basis, and assist in the evaluation and documentation of findings. * Communicate ...

New

Ritchie Bros.

Internal Auditor

Westchester, IL

Foundational understanding of internal control frameworks (e.g., COSO) and risk management ... timely basis, and assist in the evaluation and documentation of findings. * Communicate ...

Ferrero

Senior Internal Auditor

Chicago, IL · On-site

$87K - $108K/yr

Conduct risk assessments, identify key risks, and contribute to the development of risk based audit ... and / Assistant Manager, ensuring high standards and effective teamwork. Contribute to the ...

Ferrero

Senior Internal Auditor

Chicago, IL · On-site

$87K - $108K/yr

... risk management, and internal controls. Group Internal Audit at Ferrero offers talented ... and / Assistant Manager, ensuring high standards and effective teamwork. • Contribute to the ...

NACBA

Senior Internal Auditor

Chicago, IL · On-site

$113.03 - $150.70/hr

Conduct risk assessments, identify key risks, and contribute to the development of risk based audit ... and / Assistant Manager, ensuring high standards and effective teamwork. * Contribute to the ...

Ferrero

Senior Internal Auditor

Chicago, IL · On-site

$87K - $108K/yr

... risk management, and internal controls. Group Internal Audit at Ferrero offers talented ... and / Assistant Manager, ensuring high standards and effective teamwork. • Contribute to the ...

Onco360

Compliance Auditor

Woodridge, IL · On-site

$60K/yr

The Compliance Auditor will assist the Onco360/CareMed/ConnectMed360 Compliance Team through the ... Assists in the development and maintenance of operations audit and/or risk assessment tools ...

Onco360

Compliance Auditor

Woodridge, IL · Remote

$60K/yr

The Compliance Auditor will assist the Onco360/CareMed/ConnectMed360 Compliance Team through the ... Assists in the development and maintenance of operations audit and/or risk assessment tools ...

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Senior Manager, Corporate Compliance - Risk Adjustment

CVS Health

Northbrook, IL

$75K - $165K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 2 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,345 frontline employees who took The Breakroom Quiz

91st of 113 rated pharmacies

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.

The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.

Key Responsibilities

  • Lead the Medicare Advantage Risk Adjustment compliance program.

  • Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.

  • Assess operational processes for compliance risks related to risk adjustment activities.

  • Develop and implement corrective action plans for identified compliance issues.

  • Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.


Required Qualifications

  • Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance

  • Minimum 5 years in a leadership role

  • One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)

  • Willingness to travel up to 10% (including by plane)


Preferred Qualifications

  • Health Information Management (RHIA/RHIT)

  • Nursing - Strong understanding of clinical documentation and medical record review

  • Certified Risk Adjustment Coder (CRC) with compliance experience

  • Provider coding audit/compliance leadership experience

  • Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits


Education

Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.

Pay Range

The typical pay range for this role is:

$75,400.00 - $165,954.00


This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/12/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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