Raleigh, NC · On-site
Provide personalized primary care for older adults on Medicare, with the goal of keeping patients ... Conduct annual wellness visits and health risk assessments, requiring a holistic approach and ...
Raleigh, NC · On-site
Provide personalized primary care for older adults on Medicare, with the goal of keeping patients ... Conduct annual wellness visits and health risk assessments, requiring a holistic approach and ...
Chapel Hill, NC · Hybrid
$55.35 - $79.58/hr
Makes necessary adjustments to ensure goals are achieved and/or meet budget projections. Recognizes ... risk of impact. 2. Human Resource Stewardship/Management - Leads people toward meeting the ...
Chapel Hill, NC · Hybrid
$55.35 - $79.58/hr
Makes necessary adjustments to ensure goals are achieved and/or meet budget projections. Recognizes ... risk of impact. 2. Human Resource Stewardship/Management - Leads people toward meeting the ...
Chapel Hill, NC · On-site
$115 - $166/hr
Makes necessary adjustments to ensure goals are achieved and/or meet budget projections. Recognizes ... risk of impact. 2. Human Resource Stewardship/Management - Leads people toward meeting the ...
Chapel Hill, NC · On-site
$115 - $166/hr
Makes necessary adjustments to ensure goals are achieved and/or meet budget projections. Recognizes ... risk of impact. 2. Human Resource Stewardship/Management - Leads people toward meeting the ...
Chapel Hill, NC · On-site
$55.35 - $79.58/hr
Makes necessary adjustments to ensure goals are achieved and/or meet budget projections. Recognizes ... risk of impact. 2. Human Resource Stewardship/Management - Leads people toward meeting the ...
Chapel Hill, NC · On-site
$55.35 - $79.58/hr
Makes necessary adjustments to ensure goals are achieved and/or meet budget projections. Recognizes ... risk of impact. 2. Human Resource Stewardship/Management - Leads people toward meeting the ...
Raleigh, NC · On-site
$92.97 - $129.23/hr
Support implementation readiness activities, including dependency tracking, risk identification ... Direct experience supporting CMS MA encounter submission implementations * Familiarity with CMS ...
Raleigh, NC · On-site
$92.97 - $129.23/hr
Support implementation readiness activities, including dependency tracking, risk identification ... Direct experience supporting CMS MA encounter submission implementations * Familiarity with CMS ...
$92K - $129K/yr
Support implementation readiness activities, including dependency tracking, risk identification ... Direct experience supporting CMS MA encounter submission implementations * Familiarity with CMS ...
$92K - $129K/yr
Support implementation readiness activities, including dependency tracking, risk identification ... Direct experience supporting CMS MA encounter submission implementations * Familiarity with CMS ...
Raleigh, NC · On-site
$92K - $129K/yr
Support implementation readiness activities, including dependency tracking, risk identification ... Direct experience supporting CMS MA encounter submission implementations * Familiarity with CMS ...
Raleigh, NC · On-site
$92K - $129K/yr
Support implementation readiness activities, including dependency tracking, risk identification ... Direct experience supporting CMS MA encounter submission implementations * Familiarity with CMS ...
... Medicare, OSHA, HIPAA, and Corporate Compliance. Maintains all standards required for state ... Board of Directors ESSENTIAL FUNCTIONS: Develop goals and objectives for the department and ...
... Medicare, OSHA, HIPAA, and Corporate Compliance. Maintains all standards required for state ... Board of Directors ESSENTIAL FUNCTIONS: Develop goals and objectives for the department and ...
Be Seen First
Raleigh, NC · On-site
$112K - $113K/yr
Direct and optimize the use of staff, contractors, consultants, and other program resources ... Lead program risk management , proactively identifying, assessing, mitigating, and monitoring risks ...
New
Quick apply
Be Seen First
Raleigh, NC · On-site
$112K - $113K/yr
Direct and optimize the use of staff, contractors, consultants, and other program resources ... Lead program risk management , proactively identifying, assessing, mitigating, and monitoring risks ...
New
Raleigh, NC · On-site +1
$118K - $135K/yr
... risk stratification protocol. In partnership with contracted provider groups, the APP serves as an ... Must be eligible to participate in the Medicare program as a provider and registered * Valid state ...
Raleigh, NC · On-site +1
$118K - $135K/yr
... risk stratification protocol. In partnership with contracted provider groups, the APP serves as an ... Must be eligible to participate in the Medicare program as a provider and registered * Valid state ...
... Medicare Fee-for-Service patients in Durham and itssurrounding areas. Population Health Care ... Engage with direct reports on a monthly basis via monthly individual supervision and larger team ...
... Medicare Fee-for-Service patients in Durham and itssurrounding areas. Population Health Care ... Engage with direct reports on a monthly basis via monthly individual supervision and larger team ...
... Medicare Fee-for-Service patients in Durham and itssurrounding areas. Population Health Care ... Engage with direct reports on a monthly basis via monthly individual supervision and larger team ...
... Medicare Fee-for-Service patients in Durham and itssurrounding areas. Population Health Care ... Engage with direct reports on a monthly basis via monthly individual supervision and larger team ...
... Medicare Fee-for-Service patients in Durham and itssurrounding areas. Population Health Care ... Engage with direct reports on a monthly basis via monthly individual supervision and larger team ...
... Medicare Fee-for-Service patients in Durham and itssurrounding areas. Population Health Care ... Engage with direct reports on a monthly basis via monthly individual supervision and larger team ...
$19.25 - $25/hr
... risk and hazards which maximizes profitability. SSI's success is dependent upon listening and ... Minimum of 3 years full time direct clinical experience in an acute medical or acute surgical ...
$19.25 - $25/hr
... risk and hazards which maximizes profitability. SSI's success is dependent upon listening and ... Minimum of 3 years full time direct clinical experience in an acute medical or acute surgical ...
Durham, NC · On-site
$19.25 - $25/hr
... risk and hazards which maximizes profitability. SSI's success is dependent upon listening and ... Minimum of 3 years full time direct clinical experience in an acute medical or acute surgical ...
Durham, NC · On-site
$19.25 - $25/hr
... risk and hazards which maximizes profitability. SSI's success is dependent upon listening and ... Minimum of 3 years full time direct clinical experience in an acute medical or acute surgical ...
... risk factors; when directed, performance of targeted coding and/or documentation audits of DHA ... The Federal Register, Center for Medicare, and Medicaid Services (CMS) Local Coverage ...
... risk factors; when directed, performance of targeted coding and/or documentation audits of DHA ... The Federal Register, Center for Medicare, and Medicaid Services (CMS) Local Coverage ...
Durham, NC · On-site
Under direct supervision* of a certified clinician, assist certified and/or licensed practitioners ... Execute modifications, adjustments, and repairs as determined by the supervising clinician.
Durham, NC · On-site
Under direct supervision* of a certified clinician, assist certified and/or licensed practitioners ... Execute modifications, adjustments, and repairs as determined by the supervising clinician.
Durham, NC · On-site
Under direct supervision* of a certified clinician, assist certified and/or licensed practitioners ... Execute modifications, adjustments, and repairs as determined by the supervising clinician.
Durham, NC · On-site
Under direct supervision* of a certified clinician, assist certified and/or licensed practitioners ... Execute modifications, adjustments, and repairs as determined by the supervising clinician.
Reports directly to Clinical Operations Director Key Responsibilities/Critical Functions Clinical ... Identify risk factors including safety concerns, crisis situations, and social needs. * Develop ...
Reports directly to Clinical Operations Director Key Responsibilities/Critical Functions Clinical ... Identify risk factors including safety concerns, crisis situations, and social needs. * Develop ...
Raleigh, NC · On-site
$87K - $187K/yr
... care to adults on medicare to keep them happy, healthy, and out of the hospital. Nurse ... Administer annual wellness visits and health risk assessments, which require a holistic view of ...
Raleigh, NC · On-site
$87K - $187K/yr
... care to adults on medicare to keep them happy, healthy, and out of the hospital. Nurse ... Administer annual wellness visits and health risk assessments, which require a holistic view of ...
$99.2K - $102.8K
2% of jobs
$102.8K - $106.5K
2% of jobs
$106.5K - $110.2K
2% of jobs
$110.2K - $113.8K
2% of jobs
$113.8K - $117.5K
2% of jobs
$117.5K - $121.2K
2% of jobs
$121.2K - $124.8K
2% of jobs
$124.8K - $128.5K
2% of jobs
$128.5K - $132.2K
2% of jobs
$132.2K - $135.8K
2% of jobs
$136K is the 25th percentile. Wages below this are outliers.
$135.8K - $139.5K
78% of jobs
$99.2K
$132.1K
$139.5K
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.
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.
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.
The most popular types of Medicare Risk Adjustment jobs in Raleigh, NC are:
For Director Medicare Risk Adjustment jobs in Raleigh, NC, the most frequently searched job titles are:
The top searched job categories for Director Medicare Risk Adjustment jobs in Raleigh, NC are:
Cities near Raleigh, NC with the most Director Medicare Risk Adjustment job openings:
Raleigh, NC • On-site
Other
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 22 days ago
Sourced by ZipRecruiter
Inspire Healthcare, based in Boynton Beach, FL, US, is a dynamic firm in the healthcare staffing industry. Established with the dedication to provide a quality recruitment service to the healthcare sector, it is dedicated to assisting healthcare providers with their staffing needs. Its official website, ihcrecruiting.com, presents a comprehensive portfolio of services that cater to diverse healthcare facilities and positions. Its mission is firmly rooted in delivering professional healthcare staffing services that fulfill clients' needs efficiently and effectively, while also creating prosperous opportunities for healthcare professionals. A notable achievement of the company is its breadth of service, extending its recruiting coverage all across the country.
Recruiting and staffing services
11 - 50 Employees
Boynton Beach, FL, US
