Freelance Hcc Risk Adjustment Coder Jobs in Phoenix, AZ

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 ourselves accountable 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.

The Senior Medical Director will join the team at a critical time in the history of our company and of primary care. The opportunity for impact is large and growing, with our company leading the transition from fee-for-service to value-based care. The Senior Medical Director will be responsible for leading our provider teams in the local market. The Senior Medical Director will partner with the Regional Vice President to achieve operational and clinical excellence and world class performance in hospital admissions, quality, patient satisfaction, clinician satisfaction, and medical cost. To offer context for the practice and to remain close to our patients, the Senior Medical Director will practice primary care in our clinics 2 1/2 days per week alongside his/her provider colleagues. The Senior Medical Director will report to the Executive Medical Director for the region. Additionally, we see this leader as a key thought partner in providing feedback on our clinical model.

• Medical Director Management & Coaching: The Senior Medical Director will lead and mentor the health center Medical Directors in his/her region. This includes:
• Supervising center medical directors and ensuring their priorities are in line with those of the organization. This includes but is not limited to supporting the medical directors as they manage their teams, being the "go-to" for all questions, and communicating updates and business priorities, including:
• Assisting in offering constructive feedback to providers to improve performance.
• Helping medical directors master data-driven tools and practices required to keep patients well and out of the hospital.
• Reviewing quality dashboards with medical directors, and implementing initiatives to improve quality outcomes.
• Providing managed care perspective to medical directors as they lead their teams.
• Understanding and communicating provider performance/compensation plans.
• The Senior Medical Director will be responsible for interviewing, hiring, and retaining providers throughout the region.
• Physician Leadership Development: The Senior Medical Director will develop physician leadership in providers throughout the market, with support from Provider Services. This includes:
• Developing a pipeline of internal clinical leaders who are skilled in problem solving, communication, conflict resolution, value-based care delivery, and collaboration with clinicians and executives.
• Support Organizational Strategy: The Senior Medical Director\'s duties are primarily focused on the management of his/her market, but in addition, the Senior Medical Director will have input into a variety of organizational-wide projects, and will join committees for clinical programs to support the enhancement of the care model, including:
• Medical Management
• Care Management
• Quality Improvement
• Utilization Management
• Network Management
• Health Plan Management
• Documentation/Risk Adjustment
• Clinical Compliance & Policy Development
• This includes representing the company to external partners (e.g., payers, providers) and creating relationships and partnerships that support our mission and our economics.
• Population Health: As a part of the Population Health program, the Senior Medical Director is responsible for:
• Supervising the interdisciplinary Complex Care Teams focused on our highest need patients in the market.
• Supervising the Transitions Nurses, who track all hospitalized patients and coordinate post-discharge care.
• Partnering with the population health and quality teams to advance our care model.
• Participating in documentation and coding activities, including provider education and review sessions.
• Other duties, as assigned.

M.D. / D.O. / DNP graduates with license in good standing with no restrictions, Physicians will be board certified in Internal Medicine or Family Medicine. DNPs should be certified in a primary care domain. Board certified in Internal Medicine or Family Medicine. Fellowship training in Geriatrics and/or other professional degrees (e.g., M.B.A., J.D., M.P.H.) welcome but certainly not required. Typically 10+ years experience; Minimum of 5 years of experience in outpatient practice. Minimum of 3 years of experience in a physician management role or role as medical director, managing a medical group of 20 or more providers. Extensive experience in clinical leadership roles, leading and coaching physicians to be the best they can be for their patients and their colleagues. Experience with managed care and/or value-based practice and familiarity with payer-provider collaboration. Experience using a metrics-driven approach to analyze cost, quality, and satisfaction data to drive clinical strategy and program redesign. Excited by developing and implementing new processes. Self aware and confident in their leadership skills and eager to share those with a fast growing, passionate team on the leading edge of healthcare innovation. Understand the basics of managed care and recognize that population health and a focus on smart allocation of scarce resources can lead to high value care (better care, lower cost). Ability to remain calm in stressful situations. Commitment to our patient population. Comfort with ambiguity and a strong desire for problem solving.

Anticipated Weekly Hours
40

Time Type
Full time

Pay Range
The typical pay range for this role is:

$184,112.00 - $396,550.00

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.

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 full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being 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: 07/14/2027

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