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Evening Risk Adjustment Specialist Jobs (NOW HIRING)

MetroPlusHealth

Risk Adjustment Specialist

Manhattan, NY · Hybrid

$72K - $82K/yr

As a Risk Adjustment Specialist, you will support ongoing processes and lead projects to ensure MetroPlusHealth is fully capturing data about our high-risk populations and submitting accurate ...

New

MetroPlusHealth

Risk Adjustment Specialist

Manhattan, NY · On-site

$72K - $82K/yr

As a Risk Adjustment Specialist, you will support ongoing processes and lead projects to ensure MetroPlusHealth is fully capturing data about our high-risk populations and submitting accurate ...

New

The Alliance

Risk Adjustment Director

California, MO · On-site

$200 - $250/hr

... services, and specialist services * Develop, plan, organize, and direct finance programs and ... Medicare risk adjustment processes, a minimum of two years of experience related to Medicare ...

Sentara Health

Risk Adjustment Coder

Virginia Beach, VA · Hybrid

$10K/mo

Risk Adjustment Coding & Documentation Specialist, Talroo-Allied Health, Medical Office Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and ...

Molina Healthcare

Auditor, Risk Adjustment (Remote)

$49K - $107K/yr

... specialist performance.. • Facilitates audits on external Molina vendor performance. Required Qualifications • At least 5 years of coding, medical record chart review, and risk adjustment data ...

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Evening Risk Adjustment Specialist information

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$11K

$142.3K

$190K

How much do evening risk adjustment specialist jobs pay per year?

As of Aug 9, 2026, the average yearly pay for evening risk adjustment specialist in the United States is $142,322.00, according to ZipRecruiter salary data. Most workers in this role earn between $132,500.00 and $132,500.00 per year, depending on experience, location, and employer.

What is the difference between Evening Risk Adjustment Specialist vs Risk Adjustment Analyst?

AspectEvening Risk Adjustment SpecialistRisk Adjustment Analyst
Required CredentialsTypically requires healthcare or insurance certifications, such as CPC or RHIAOften requires similar certifications, with additional data analysis or coding credentials
Work EnvironmentPrimarily in healthcare or insurance offices, with evening shiftsIn office or remote, focusing on data analysis during standard or flexible hours
Employer & Industry UsageUsed by health plans, hospitals, and insurance companies for risk managementUsed by insurance companies and healthcare analytics firms for data evaluation

The Evening Risk Adjustment Specialist focuses on managing risk adjustment processes during evening hours, often involving claims review and coding. The Risk Adjustment Analyst typically performs data analysis and reporting to support risk management strategies. While both roles require healthcare or insurance certifications, the specialist role emphasizes operational tasks during evening shifts, whereas the analyst role centers on data interpretation and analysis during regular hours.

More about Evening Risk Adjustment Specialist jobs
What cities are hiring for Evening Risk Adjustment Specialist jobs? Cities with the most Evening Risk Adjustment Specialist job openings:
What are the most commonly searched types of Risk Adjustment Specialist jobs? The most popular types of Risk Adjustment Specialist jobs are:
What states have the most Evening Risk Adjustment Specialist jobs? States with the most job openings for Evening Risk Adjustment Specialist jobs include:
What job categories do people searching Evening Risk Adjustment Specialist jobs look for? The top searched job categories for Evening Risk Adjustment Specialist jobs are:
Evening Risk Adjustment Specialist jobs near you
Infographic showing various Evening Risk Adjustment Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 88% Full Time, 8% Part Time, and 3% Contract. Highlights an 88% Physical, 4% Hybrid, and 8% Remote job distribution, with an average salary of $142,322 per year, or $68.4 per hour.

Risk Adjustment Specialist

MetroPlusHealth

Manhattan, NY • Hybrid

$72K - $82K/yr

Full-time

Posted 3 days ago

New

MetroPlusHealth rating

6.7

Company rating: 6.7 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

264th of 304 rated insurance

Job description

Position Overview

Risk Adjustment is a growing and critical field within Health Insurance Finance. This is your opportunity

to support this function at MetroPlusHealth, New York City’s not-for-profit health insurance company. As a Risk Adjustment Specialist, you will support ongoing processes and lead projects to ensure MetroPlusHealth is fully capturing data about our high-risk populations and submitting accurate information to federal and state agencies. You will work independently to monitor and support internal partners and external vendors in data collection and submission. You’ll apply your problem-solving skills to resolve issues you identify. You will also calculate errors and acceptance rates to track progress over time.

This opportunity is ideal for an individual interested in working at the intersection of Health Insurance Analytics and Operations, who excels at creative problem solving, is detail-oriented, and who is committed to our mission of providing access to health insurance to all New Yorkers.

Scope of Role and Responsabilities 

  • Ongoing monitoring of data submitted by vendors to ensure project goals are being met,
  • submitted data is complete and accurate, and errors are identified quickly.
  • Proactively work with external and internal partners to resolve issues – this includes identifying the root cause, devising plans to remediate, and ensuring on-time completion from all stakeholders.
  • Support end-to-end submission processes and encounter data across all lines of business, including Medicaid, Medicare and Affordable Care Act/QHP. This includes monitoring submission timelines, resubmissions, and validating accepted and rejected encounter metrics to ensure data is accurately reflected in downstream reporting.
  • Perform financial impact analysis of Risk Adjustment activities, including implications of data errors, missed submissions, and remediation efforts.
  • Access and analyze data within the enterprise data warehouse to evaluate member, provider, claims, and enrollment data in support of Risk Adjustment and encounter data initiatives.
  • Utilize dashboards to identify trends and potential opportunities in data collection and reportng. 

Required Education, Training & Professional Experience

  • Bachelor’s degree required, with a demonstrated interest in Finance, Social Services or Health Care.
  • Minimum of 3-4 years’ experience required working for a Health Plan, or in a Finance, Project Management or Actuarial capacity in another industry.
  • Ability to work independently to investigate, pinpoint, and resolve problems.
  • Strong analytical and financial skills. Experience using SQL, R, SAS or another programming language is a plus.
  • Proactive communication style and ability to work with a variety of stakeholders to achieve project goals.

Professional Competencies 

  • Integrity and Trust
  • Customer Focus
  • Functional/Technical skills
  • Written/Oral Communication

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