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Hcc Risk Adjustment Jobs in Chicago, IL (NOW HIRING)

Strive Health

Nurse Practitioner

Chicago, IL · On-site

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

Strive Health

Nurse Practitioner

Schererville, IN · On-site

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

Strive Health

Nurse Practitioner

Merrillville, IN · On-site

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

Strive Health

Nurse Practitioner

Chicago, IL

$120K - $151K/yr

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

Strive Health

Nurse Practitioner

Schererville, IN

$112K - $140K/yr

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

Strive Health

Nurse Practitioner

Merrillville, IN

$112K - $140K/yr

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

All JobsHcc Risk Adjustment JobsHcc Risk Adjustment Jobs in Chicago, IL

Hcc Risk Adjustment information

See Chicago, IL salary details

$11.3K

$146.6K

$195.7K

How much do hcc risk adjustment jobs pay per year?

As of Jul 30, 2026, the average yearly pay for hcc risk adjustment in Chicago, IL is $146,613.00, according to ZipRecruiter salary data. Most workers in this role earn between $136,500.00 and $136,500.00 per year, depending on experience, location, and employer.

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

To excel in HCC Risk Adjustment, you need a solid understanding of medical coding, clinical documentation, healthcare regulations, and disease management, usually coupled with experience in coding certifications like CPC or CRC. Familiarity with Hierarchical Condition Category (HCC) models, data analytics tools, and electronic health record (EHR) systems is essential. Attention to detail, analytical thinking, and strong communication skills make a candidate stand out in this role. These skills ensure accurate risk adjustment coding and documentation, which are vital for appropriate reimbursement and compliance in the healthcare industry.

What are the main responsibilities of someone working in HCC Risk Adjustment?

Professionals in HCC Risk Adjustment are typically responsible for reviewing medical records, ensuring accurate coding of diagnoses aligned with CMS guidelines, and collaborating with providers to improve documentation. The role often involves analyzing patient data to identify risk gaps and providing education to clinical staff on best practices for compliant coding. Team members regularly coordinate with data analysts, providers, and compliance teams to support accurate reporting and optimal reimbursement. Overall, attention to detail and clear communication are key to meeting the organization's compliance and financial objectives.

What is an HCC Risk Adjustment job?

An HCC Risk Adjustment job involves reviewing medical records to ensure accurate coding of diagnoses under the Hierarchical Condition Category (HCC) model. This role helps determine risk scores for patients, which impact healthcare provider reimbursements in Medicare Advantage and other risk-adjusted programs. Professionals in this field, such as medical coders or auditors, analyze documentation to assign appropriate ICD-10-CM codes that reflect a patient's health status. Strong attention to detail and knowledge of coding guidelines are essential for success in this role.

What are the most commonly searched types of Hcc Risk Adjustment jobs in Chicago, IL? The most popular types of Hcc Risk Adjustment jobs in Chicago, IL are:
What are popular job titles related to Hcc Risk Adjustment jobs in Chicago, IL? For Hcc Risk Adjustment jobs in Chicago, IL, the most frequently searched job titles are:
What job categories do people searching Hcc Risk Adjustment jobs in Chicago, IL look for? The top searched job categories for Hcc Risk Adjustment jobs in Chicago, IL are:
Hcc Risk Adjustment jobs near you
Infographic showing various Hcc Risk Adjustment job openings in Chicago, IL 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 $146,613 per year, or $70.5 per hour.

Senior Manager, Corporate Compliance - Risk Adjustment

CVS Health

Northbrook, IL

$75K - $165K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 8 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,322 frontline employees who took The Breakroom Quiz

87th 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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