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Director Medicare Risk Adjustment Jobs (NOW HIRING)

Village Care

Risk Adjustment Coding Manager

Manhattan, NY · On-site

$102K - $115K/yr

Medicare Risk Adjustment Coding Manager Location: Remote (Must Reside in NY/NJ/CT) Work Schedule: Monday - Friday, 9:00am - 5:00pm Compensation: $102,549.17 - $115.367.82 Annual Salary Join ...

Village Care

Risk Adjustment Coding Manager

Manhattan, NY · On-site

$102K - $115K/yr

Medicare Risk Adjustment Coding Manager Location: Remote (Must Reside in NY/NJ/CT) Work Schedule: Monday - Friday, 9:00am - 5:00pm Compensation: $102,549.17 - $115.367.82 Annual Salary Join ...

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Director Medicare Risk Adjustment information

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$102K

$135.9K

$143.5K

How much do director medicare risk adjustment jobs pay per year?

As of Jun 12, 2026, the average yearly pay for director medicare risk adjustment in the United States is $135,863.00, according to ZipRecruiter salary data. Most workers in this role earn between $137,500.00 and $141,000.00 per year, depending on experience, location, and employer.

What does a Director of Medicare Risk Adjustment do?

A Director of Medicare Risk Adjustment oversees the strategy, operations, and compliance of risk adjustment programs for Medicare Advantage plans. They ensure accurate data collection, coding, and submissions to optimize reimbursement while maintaining regulatory compliance. This role involves collaborating with cross-functional teams, managing analytics, and implementing initiatives to improve documentation and risk score accuracy. Additionally, they monitor policy changes and adjust processes to align with evolving CMS regulations.

What are some common challenges faced by Directors of Medicare Risk Adjustment, and how do they impact daily work?

Directors of Medicare Risk Adjustment frequently tackle challenges such as interpreting evolving CMS guidelines, ensuring complete and accurate documentation, and aligning interdepartmental teams around risk adjustment best practices. Keeping up with regulatory changes, managing large data sets, and training staff on coding compliance are all critical aspects of the job. These challenges require strong analytical skills, attention to detail, and the ability to communicate complex information to various stakeholders. Addressing these issues effectively is key to maintaining compliance, optimizing revenue accuracy, and helping your organization deliver quality care to Medicare populations.

What are the key skills and qualifications needed to thrive in the Director Medicare Risk Adjustment position, and why are they important?

To thrive as a Director Medicare Risk Adjustment, you need a strong background in healthcare administration, Medicare regulations, data analytics, and risk adjustment methodologies, often supported by a bachelor's or master's degree in a related field. Familiarity with risk adjustment software, claims processing systems, and proficiency in data analysis tools like SQL or SAS is essential, and certifications such as CRC (Certified Risk Adjustment Coder) can be advantageous. Outstanding leadership, cross-functional collaboration, and strong communication skills help drive teams toward accurate documentation and coding compliance. These competencies are crucial for optimizing revenue, ensuring regulatory adherence, and guiding strategic organizational initiatives in a complex healthcare environment.

More about Director Medicare Risk Adjustment jobs
What cities are hiring for Director Medicare Risk Adjustment jobs? Cities with the most Director Medicare Risk Adjustment job openings:
What are the most commonly searched types of Medicare Risk Adjustment jobs? The most popular types of Medicare Risk Adjustment jobs are:
What states have the most Director Medicare Risk Adjustment jobs? States with the most job openings for Director Medicare Risk Adjustment jobs include:
What job categories do people searching Director Medicare Risk Adjustment jobs look for? The top searched job categories for Director Medicare Risk Adjustment jobs are:
Director Medicare Risk Adjustment jobs near you
Infographic showing various Director Medicare Risk Adjustment job openings in the United States as of June 2026, with employment types broken down into 7% As Needed, 46% Full Time, 43% Part Time, and 4% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $135,863 per year, or $65.3 per hour.
Medicare Risk Adjustment Specialist - Medical Assistant

Medicare Risk Adjustment Specialist - Medical Assistant

Complete Health

Jacksonville, FL • On-site

$16.50 - $20.75/hr

Full-time

Posted 17 days ago

Complete Health rating

6.8

Company rating: 6.8 out of 10

Based on 21 frontline employees who took The Breakroom Quiz

Job description

SUMMARY OF JOB DUTIES:
Searching for a strong Medical Assistant or Certified Nursing Assistant for a rapidly growing company who would like to come off the floor and become a Medicare Risk Adjustment Specialist.
ESSENTIAL JOB FUNCTIONS:
  • Reviews medical record and claims information to identify all appropriate coding based on Centers for Medicare and Medicaid Services Hierarchical Condition Categories (CMS-HCC & HHS-HCC) models
  • Abstract all risk adjusted diagnosis codes from acceptable provider documentation and in accordance with industry standards for coding and reporting.
  • Adherence to current industry standard, as defined in the ICD-10 guidelines for coding and reporting.
  • Conduct Provider queries for any documentation for risk conditions within client electronic medical record and/or other query system
  • Develop and share guidelines/best practices with internal risk adjustment coders to improve coding documentation techniques.
  • Help with special projects within our Risk Adjustment Department

KNOWLEDGE/SKILLS/ABILITIES:
  • Critical Thinking
  • Excellent time management skills and ability to multi-task and prioritize work
  • Strong organizational and planning skills
  • Flexibility
  • Team Player
  • Autonomy

MINIMUM REQUIREMENTS
  • High School Diploma or Equivalent (Required)
  • Medical Assistant or Certified Nursing Assistant
  • 2 -- 3 years Back Office, Primary Care preferred

WORKING ENVIRONMENT
The position requires climbing, stooping, kneeling, crouching, reaching, standing, lifting, grasping, feeling, talking, hearing, repetitive motions, and finger use. Pushing and pulling are occasionally required. Use of a computer, keyboard, and telephone along with various office machines is an essential part of the job.
DISCLAIMER
The above statements are intended to describe the general nature and level of work being performed by the Medicare Risk Adjustment Coder. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The Medicare Risk Adjustment Coder may be required to perform duties outside of their normal responsibilities from time to time as needed or as directed by supervision.

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