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Insurance Risk Manager Jobs in Oklahoma (NOW HIRING)

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Insurance Risk Manager information

See Oklahoma salary details

$76.2K

$112.2K

$171.7K

How much do insurance risk manager jobs pay per year?

As of Jul 14, 2026, the average yearly pay for insurance risk manager in Oklahoma is $112,190.00, according to ZipRecruiter salary data. Most workers in this role earn between $93,300.00 and $127,400.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an Insurance Risk Manager, and why are they important?

To thrive as an Insurance Risk Manager, you need expertise in risk assessment, analytical thinking, and a strong understanding of insurance principles, often supported by a relevant degree and certifications like ARM or CPCU. Familiarity with risk modeling software, statistical analysis tools, and regulatory compliance systems is typically required. Strong communication, decision-making, and problem-solving skills help you effectively advise stakeholders and manage complex risk scenarios. These abilities are crucial for identifying, evaluating, and mitigating risks to protect organizational assets and ensure regulatory compliance.

What is the difference between Insurance Risk Manager vs Insurance Underwriter?

AspectInsurance Risk ManagerInsurance Underwriter
CredentialsTypically requires a bachelor's degree in risk management, finance, or related fields; professional certifications like ARM or CPCU are commonUsually holds a bachelor's degree in finance, economics, or related areas; certifications like CPCU or ARe are beneficial
Work EnvironmentWorks in corporate risk management departments, analyzing and mitigating risks for the companyWorks in insurance companies, assessing individual or business applications to determine coverage and premiums
Employer & Industry UsageUsed by insurance companies and large corporations to manage risk exposurePrimarily employed by insurance carriers to evaluate and approve insurance policies

While both roles involve understanding insurance policies, the Insurance Risk Manager focuses on overall risk mitigation strategies within an organization, whereas the Insurance Underwriter evaluates individual insurance applications to determine coverage and pricing.

What does an Insurance Risk Manager do?

An Insurance Risk Manager is responsible for identifying, assessing, and mitigating risks that could negatively impact an organization’s assets, operations, or reputation. They analyze various types of risks—including financial, operational, and compliance risks—and develop strategies to minimize potential losses. Insurance Risk Managers also advise on appropriate insurance coverage, negotiate policies with insurers, and ensure that the company complies with relevant regulations to protect against unforeseen events.

What are the most common challenges Insurance Risk Managers face when working across different departments?

Insurance Risk Managers often collaborate with various departments such as underwriting, claims, and compliance to identify and mitigate potential risks. One common challenge is ensuring clear communication and alignment of risk policies across teams that may have different priorities or levels of risk awareness. Balancing regulatory requirements with business objectives can also be complex, requiring strong negotiation and relationship-building skills. Successfully navigating these challenges helps create a unified risk culture and strengthens the organization's overall resilience.
What are popular job titles related to Insurance Risk Manager jobs in Oklahoma? For Insurance Risk Manager jobs in Oklahoma, the most frequently searched job titles are:
What job categories do people searching Insurance Risk Manager jobs in Oklahoma look for? The top searched job categories for Insurance Risk Manager jobs in Oklahoma are:
What cities in Oklahoma are hiring for Insurance Risk Manager jobs? Cities in Oklahoma with the most Insurance Risk Manager job openings:
Insurance Risk Manager jobs near you
Risk Adjustment - Risk Adjustment Coding Analyst 135-2014

Risk Adjustment - Risk Adjustment Coding Analyst 135-2014

CommunityCare

Tulsa, OK • On-site

Full-time

Posted 22 days ago

Job description

JOB SUMMARY:
This role will report directly to the Supervisor of Clinical and Risk Coding and is responsible for clinical and risk adjustment audits for both Medicare Advantage and ACA Programs. Ensuring accurate and appropriate documentation. Audits include Vendors, provider groups, and individual providers. Will also provide medical coding support and HEDIS assistance to the Reporting department. This role will support all seasonal and ad-hoc project assignments for both clinical and risk adjustment.
KEY RESPONSIBILITIES:
  • Ensure ICD codes submitted to CMS for the Risk Adjustment Payment System are accurate, appropriate, and supported by written clinical documentation in accordance with all federal and state regulations.
  • Adhere to all official coding rules and CMS guidelines for risk adjustment programs. Ensure accuracy, completeness, specificity, and appropriateness of diagnosis information.
  • Surveillance of CPT, CMS, and other regulations and their impact related to coding and other business functions.
  • Risk Adjustment Validation Audits (RADV), conduct chart review of inpatient and outpatient medical records for Hierarchal Condition Category (HCC) coding.
  • Review results of risk adjustment audits to identify coding patterns and provide the information back to the supervisor.
  • Provide accurate data results/reports of provider claims and clinical notes audited.
  • Recommend general and specific education topics based on CMS/HHS guidelines to the supervisor in written form (e.g., email, word, etc.)
  • Meet with the supervisor to discuss potential education with the provider groups and other stakeholders to provide coding education and support.
  • Assist with the annual HEDIS medical record review process.
  • Receives assignment to evaluate Medicare Wellness Visit documentation for accuracy and completeness in addressing gaps in care and expiring HCCs. Present findings to the supervisor on a regularly scheduled basis.
  • Perform evaluation /prioritize results of new Medicare Advantage and Marketplace member self-reported health risk assessments for risk adjustment conditions that should be addressed. Create analyses, summary reporting, and coordinate with providers
  • Provide support to health data analysts on medical coding questions and follow up with the supervisor on any issues that need to be resolved.
  • Support medical record requests and retrieval projects.
  • Perform other job-related duties as assigned.

QUALIFICATIONS:
  • Extensive knowledge of ICD, HCPCS, and CPT codes.
  • Knowledge of risk adjustment payment models and risk adjustment coding preferred
  • Familiarity with State and federal regulations governing healthcare preferred
  • Health plan/medical practice experience
  • Medicare Advantage and ACA knowledge preferred
  • Able to work independently and meet stringent deadlines.
  • Strong attention to detail.
  • Possess strong oral and written communication skills
  • Successful completion of Health Care Sanctions background check.
  • Proficient in Microsoft Office applications.

Metric Requirements
Performance will be evaluated using the following indicators:
  • Quality
    • Audit Accuracy Rate: ≥ 95-98% coding accuracy
    • Documentation Defensibility Score: 100% alignment with MEAT/ICD-10-CM standards
    • Compliance Audit Pass Rate: Minimum threshold set by organization (e.g., ≥ 95%)
  • Productivity
    • Audit Volume: 25-30 charts/cases per day or week (based on specialty and chart type)
    • Turnaround Time: Meets established SLA for completion (e.g., 48-72 hours per batch)
  • Improvement Impact
    • Reduction in Repeat Findings: Continuous improvement trend quarter-to-quarter
    • Timely Remediation Rate: ≥ 90% of corrections and follow-ups completed within the required timeframe
    • Provider/Coder Feedback Engagement: Participation in education aligned with audit trends
  • Financial Integrity
    • RAF Score Accuracy: Maintains accurate correlation between HCC capture and reimbursement
    • Lost Revenue Opportunity Reduction: Identifies and prevents under-coding where compliant and appropriate

EDUCATION/EXPERIENCE:
  • Coding certification nationally recognized by the AAPC or AHIMA is required.
  • Minimum of two years of coding experience utilizing ICD-CM coding required.
  • Experience or familiarity with state and federal regulations governing healthcare.
  • Two years' experience with claims processing systems, coding programs, and electronic medical records preferred.
  • Previous HMO or health insurance experience preferred.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin

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