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Hcc Risk Adjustment Coding Jobs in Phoenix, AZ (NOW HIRING)

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

The Associate, Risk Adjustment Auditor conducts internal and external quality audits ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Cliff Services Inc

Data Risk Analyst

Phoenix, AZ · On-site

... HCC to isolate coding discrepancies or revenue gaps Audit Support Provide backend reporting and data validation to assist with internal quality checks and federal Risk Adjustment Data Validation RADV ...

Valleywise Health System

CDI Specialist RN Ld

Phoenix, AZ · On-site

$39.96 - $58.94/hr

Advanced knowledge of ICD-10-CM/PCS, MS-DRG/APR-DRG methodologies, risk adjustment, and coding compliance. * Strong clinical validation expertise and critical-thinking skills. * Ability to deliver ...

Ryan House

Senior Data & AI Engineer

Phoenix, AZ · On-site

$105K - $143K/yr

Medicare fee-for-service, MA, Medicaid, CCW, APCD, and quality programs; risk adjustment (HCC), HEDIS measures • MLOps & DevOps: MLflow, DVC, GitHub Actions/Azure DevOps, containerization (Docker ...

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Hcc Risk Adjustment Coding information

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$13

$27

$43

How much do hcc risk adjustment coding jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for hcc risk adjustment coding in Phoenix, AZ is $27.11, according to ZipRecruiter salary data. Most workers in this role earn between $20.43 and $33.27 per hour, depending on experience, location, and employer.

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

To thrive as an HCC Risk Adjustment Coder, you need a strong understanding of medical coding guidelines, ICD-10-CM codes, and risk adjustment principles, typically supported by a certification such as CPC, CRC, or CCS-P. Familiarity with electronic health record systems and risk adjustment software is essential for accurate coding and data analysis. Attention to detail, critical thinking, and effective communication skills are important soft skills for ensuring documentation integrity and collaborating with healthcare providers. These competencies are crucial to accurately capture patient complexity, optimize reimbursement, and support compliance in healthcare organizations.

What are the typical challenges faced by HCC Risk Adjustment Coders, and how can they overcome them?

HCC Risk Adjustment Coders often face challenges such as interpreting complex medical records, staying up-to-date with evolving coding guidelines, and ensuring thorough documentation to support accurate risk scoring. To overcome these challenges, coders should engage in continuous education, collaborate closely with healthcare providers for clarification, and utilize available coding resources and team support. Staying organized and maintaining a detail-oriented approach will also help ensure that codes are assigned correctly and all relevant conditions are captured. Working as part of a supportive team can further ease the process, providing opportunities for knowledge sharing and professional development.

What is an HCC Risk Adjustment Coding job?

An HCC Risk Adjustment Coding job involves reviewing medical records to assign Hierarchical Condition Category (HCC) codes based on documented diagnoses. Coders ensure accurate risk adjustment by following ICD-10-CM coding guidelines, which impact reimbursement for healthcare providers and insurance plans. This role requires knowledge of medical terminology, compliance regulations, and risk adjustment models used in Medicare Advantage and other programs.

What are the most commonly searched types of Hcc Risk Adjustment Coding jobs in Phoenix, AZ? The most popular types of Hcc Risk Adjustment Coding jobs in Phoenix, AZ are:
What are popular job titles related to Hcc Risk Adjustment Coding jobs in Phoenix, AZ? For Hcc Risk Adjustment Coding jobs in Phoenix, AZ, the most frequently searched job titles are:
What job categories do people searching Hcc Risk Adjustment Coding jobs in Phoenix, AZ look for? The top searched job categories for Hcc Risk Adjustment Coding jobs in Phoenix, AZ are:
Hcc Risk Adjustment Coding jobs near you
Infographic showing various Hcc Risk Adjustment Coding job openings in Phoenix, AZ as of July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, and 7% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution, with an average salary of $56,392 per year, or $27.1 per hour.
Senior Manager, Corporate Compliance - Risk Adjustment

Senior Manager, Corporate Compliance - Risk Adjustment

CVS Health

Scottsdale, AZ

$75K - $165K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 4 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,317 frontline employees who took The Breakroom Quiz

88th of 109 rated pharmacies

Job description

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 ourselvesaccountable 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.

Position Summary

As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.

The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.

Key Responsibilities

  • Lead the Medicare Advantage Risk Adjustment compliance program.

  • Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.

  • Assess operational processes for compliance risks related to risk adjustment activities.

  • Develop and implement corrective action plans for identified compliance issues.

  • Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.


Required Qualifications

  • Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance

  • Minimum 5 years in a leadership role

  • One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)

  • Willingness to travel up to 10% (including by plane)


Preferred Qualifications

  • Health Information Management (RHIA/RHIT)

  • Nursing - Strong understanding of clinical documentation and medical record review

  • Certified Risk Adjustment Coder (CRC) with compliance experience

  • Provider coding audit/compliance leadership experience

  • Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits


Education

Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.

Pay Range

The typical pay range for this role is:

$75,400.00 - $165,954.00


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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

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 fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing 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: 08/12/2026

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

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