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Director Health Plan Risk Adjustment Jobs (NOW HIRING)

Zing Health Holdings Inc

IL · On-site

$85K - $90K/yr

The ideal candidate is a self-directed professional with strong project management skills, deep ... Experience supporting health plan risk adjustment operations. * Experience developing coding ...

Mass Advantage

Manager, Risk Adjustment

Worcester, MA · On-site

Description Mass Advantage is a Medicare Advantage health plan, located in the heart of Worcester ... Direct, hands-on RADV experience - working fluency with the CMS-HCC model, including the V24-V28 ...

Viva Health

Senior Risk Adjustment Specialist

Birmingham, AL · On-site

$92K/yr

... health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern ... Train and mentor new Risk Adjustment Specialists. * Assist management with workflow improvements ...

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Director Health Plan Risk Adjustment information

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$54K

$143.2K

$260K

How much do director health plan risk adjustment jobs pay per year?

As of Sep 13, 2026, the average yearly pay for director health plan risk adjustment in the United States is $143,185.00, according to ZipRecruiter salary data. Most workers in this role earn between $105,500.00 and $167,500.00 per year, depending on experience, location, and employer.

What is the difference between Director Health Plan Risk Adjustment vs Health Plan Risk Adjustment Analyst?

AspectDirector Health Plan Risk AdjustmentHealth Plan Risk Adjustment Analyst
CredentialsTypically requires advanced degrees (e.g., Master’s), certifications like CPC, CRC, or RHIA, and extensive experienceOften requires a bachelor’s degree, certifications like CPC or CRC, and entry to mid-level experience
Work EnvironmentLeadership roles overseeing teams, strategy, and compliance within health plansData analysis, coding, and reporting tasks within health plan operations
Employer & Industry UsageUsed in health insurance companies, managed care organizations, and healthcare consulting firmsCommonly employed in health plans, healthcare providers, and analytics firms

The main difference is that the Director Health Plan Risk Adjustment holds a leadership role with strategic responsibilities, while the Health Plan Risk Adjustment Analyst focuses on data analysis and coding tasks. The director oversees teams and ensures compliance, whereas analysts support operational functions within the risk adjustment process.

What are popular job titles related to Director Health Plan Risk Adjustment jobs?

For Director Health Plan Risk Adjustment jobs, the most frequently searched job titles are:

Infographic showing various Director Health Plan Risk Adjustment job openings in the United States as of September 2026, with employment types broken down into 2% As Needed, 76% Full Time, 17% Part Time, and 5% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $143,185 per year, or $68.8 per hour.

Program Director, National Risk & Quality Solutions (Remote)

Remote

Molina Healthcare
Health Care and Social Assistance • 10K+ employees
Learn more about Molina Healthcareexternal

$79K - $172K/yr

Full-time

Posted 6 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

Job description


JOB DESCRIPTION Job Summary
Provides deep subject matter expertise for enterprise Molina risk and quality solutions (RQS) activities. Collaborates with health plan risk and quality leaders to support implementation of best quality/risk practices for optimal performance. Ensures that all RQS action plans are complete, accurate and reflect objectives necessary to achieve established risk/quality performance goals.
Essential Job Duties
• Provides risk and quality support to a selection of state health plans; leverages established risk and quality solutions (RQS) best practices to support health plan achievement of risk/quality goals, with oversight senior quality/risk adjustment leadership.
• Serves as a risk/quality industry subject matter expert to functional areas/health plans, and leads risk/quality-related programs to meet critical needs.
• Escalates gaps and barriers in risk/quality programs/initiatives implementation and compliance to leadership; partners with the execution team for resolution and barrier removal impeding health plan execution.
• Represents in a consultative role, supporting development of business case methodologies for incremental risk/quality programs; develops and coordinates implementation of business strategies.
• Collaborates and facilitates risk/quality-related activities with corporate/health plan teams.
Required Qualifications
• At least 8 years of managed care experience, including risk adjustment/quality-related experience supporting Medicaid, Medicare, and/or Marketplace, or equivalent combination of relevant education and experience.
• At least 3 years of management/leadership experience.
• Proficiency with risk adjustment methodologies.
• Quality/risk operational and process improvement experience.
• Proficiency with data analysis, manipulation and interpretation.
• Critical-thinking, problem-solving and analytical skills.
• Attention to detail and organizational skills.
• Ability to work cross-collaboratively in a highly matrixed organization.
• Ability to collaborate and drive/influence change and initiatives with internal/external stakeholders.
• Project management experience.
• Excellent verbal/written communication skills, and presentation skills.
• Microsoft Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs.
Preferred Qualifications
• Strong quality/risk adjustment project-related experience.
• Prior experience with Centers for Medicare and Medicaid Services (CMS) risk adjustment-related initiatives.
• Advanced knowledge and understanding of HEDIS and NCQA.
• Certified Professional in Healthcare Quality (CPHQ).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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