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Hcc Risk Adjustment Jobs (NOW HIRING)

PedIM Healthcare

HCC Coder

Lecanto, FL

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

TEKsystems

Risk Adjustment Coding Auditor

Phoenix, AZ · Remote

$32 - $37/hr

The ideal candidate will bring extensive HCC coding and risk adjustment auditing experience, strong analytical skills, and a thorough understanding of Medicare, Medicaid, and ACA risk adjustment ...

PedIM Healthcare

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

PedIM Healthcare

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

PedIM Healthcare

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

Aquity Solutions

Director Risk Adjustment - Remote

$130K - $150K/yr

Act as the internal authority on CMS-HCC coding updates, as well as future strategic expansion into commercial coding and state-specific Medicaid lines of business, ensuring all risk adjustment ...

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All JobsHcc Risk Adjustment Jobs

Hcc Risk Adjustment information

See salary details

$11K

$142.3K

$190K

How much do hcc risk adjustment jobs pay per year?

As of Aug 12, 2026, the average yearly pay for hcc risk adjustment 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 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?

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.

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What cities are hiring for Hcc Risk Adjustment jobs? Cities with the most Hcc Risk Adjustment job openings:
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Hcc Risk Adjustment jobs near you
Infographic showing various Hcc Risk Adjustment 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, 5% Hybrid, and 7% Remote job distribution, with an average salary of $142,322 per year, or $68.4 per hour.

Manager, Risk Adjustment

Central Mass Health LLC

Worcester, MA • On-site

$90K/yr

Full-time

Re-posted 26 days ago

Job description

Mass Advantage is a Medicare Advantage health plan, located in the heart of Worcester County, headquartered in Worcester MA. Mass Advantage is owned and designed by UMass Memorial Health providers with their patients' needs in mind.
We are looking for a Manager of Risk Managment to oversee Mass Advantages's full suite of Risk Adjustment activities. This position is responsible for the strategy, execution and performance of Medicare risk adjustment programs, infrastructure and systems to meet business objectives, revenue expectations, management of external vendors, interaction with Providers, regulatory audits, and compliance with CMS regulations. The Manager of Risk Management is also responsible for analysis, projections, and assessment of Medicare revenue initiatives for senior products; leading and coordinating enterprise risk adjustment initiatives, working with the necessary areas of Mass Advantage and UMass Memorial Health Operations as well as vendor partners.
Essential Duties and Responsibilities:
Program Strategy & Execution
  • Own end-to-end RA strategy across prospective (point-of-care capture, suspecting, provider workflows) and retrospective (chart review, coding validation) programs, ensuring complete, accurate, and compliant HCC documentation under the applicable CMS-HCC model (including V24 -V28 transition management).
  • Evaluate current vendor performance, renegotiating or sunsetting SOWs where internal capability is superior.
  • Serve as the plan-side counterpart to UMMH CDI, HIM, and Coding leadership, coordinating with the CMO's office to embed documentation workflows into Epic-based clinical practice rather than layered on top of it.
  • Partner with Network and Clinical Services to design provider-facing education, scorecards, and incentive structures that drive documentation accuracy without creating coding-driven behavior.
  • Develop provider-level performance reporting that is transparent, defensible, and actionable.

RADV, Audit & Compliance
  • Lead RADV audit readiness and response, including medical record retrieval, validation, submission strategy, and cross-functional coordination with Legal, Compliance, and Finance to mitigate financial and compliance risk.
  • Maintain a comprehensive QA program covering RADV, OIG, and internal audits - monitoring the work of internal coders, contracted vendors, and provider documentation alike.
  • Own encounter data integrity, including EDPS submission accuracy, RAPS/EDPS reconciliation, and error resolution.

Analytics, Finance & Bid Support
  • Build and maintain the RA analytics layer - dashboards, KPIs, and provider/member-level reporting that drive continuous improvement in risk score accuracy, coding yield, and program ROI.
  • Partner with Actuarial and Finance on bid development, producing defensible risk score projections, trend analysis, and revenue assumptions grounded in population severity and program performance.
  • Communicate results to executive and board audiences through clear reports, dashboards, and presentations.

Program & Team Leadership
  • Set departmental goals, budgets, and tactical plans aligned with enterprise strategy and financial targets.
  • Other duties may be assigned as needed.

* Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Requirements
  • Bachelor's degree in a relevant field; Master's (MBA, MHA, MPH) preferred.
  • Registered Nurse (RN) desired.
  • CRC (Certified Risk Adjustment Coder), CPC, or CCS certification preferred.
  • 7+ years in Medicare Advantage risk adjustment, with at least 3 years in a plan-side role (not solely provider-side or vendor-side).
  • Direct, hands-on RADV experience - working fluency with the CMS-HCC model, including the V24-V28 transition and its financial implications.
  • Demonstrated experience managing or transitioning RA vendors (coding, chart retrieval, in-home assessment).
  • Strong analytical skills: able to interrogate data directly in SQL, Power BI, or Tableau, or to spec analytics requirements with precision.+
  • Strong Microsoft Office skills (Word, Outlook, Excel and PP).

Salary Description
Starting at $90K

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