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Manager Hcc Risk Adjustment Jobs in California (NOW HIRING)

Medix

Risk Adjustment Director

Scotts Valley, CA · On-site

$96.15 - $120.19/hr

... Medicare Managed Care Programs. * 3 years of supervisory experience. * Expert knowledge of Medicare HCC risk adjustment models. * Working knowledge of CPT, HCPCS, and ICD-9/10 medical coding.

Molina Healthcare

VP, Risk Adjustment

Long Beach, CA

$137K - $184K/yr

Leads end-to-end program management for chart review initiatives, in-home assessments (IHA ... HCC) methodology, Medicaid risk adjustment guidelines, and ACA Marketplace risk adjustment ...

Molina Healthcare

VP, Risk Adjustment

Long Beach, CA · On-site +1

$137K - $184K/yr

Leads end-to-end program management for chart review initiatives, in-home assessments (IHA ... HCC) methodology, Medicaid risk adjustment guidelines, and ACA Marketplace risk adjustment ...

Astiva Health

Healthcare Data Analyst

Orange, CA · On-site

$85K - $115K/yr

Experience working in Medicare Advantage organizations, MSOs, or managed care settings. * Knowledge of HCC risk adjustment, RAF methodologies, capitation payment model, DOFR, claim processing, bid ...

Urrly

Telehealth Nurse Practitioner

Los Angeles, CA · Remote

$600 - $720/day

Document HCC (risk adjustment) during visits * Close HEDIS (quality measures) care gaps * Review history, meds, preventive needs * Code with ICD-10 and CPT II * Deliver care plans and follow-up * ...

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Manager Hcc Risk Adjustment information

What is the difference between Manager Hcc Risk Adjustment vs Hcc Risk Adjustment Specialist?

AspectManager Hcc Risk AdjustmentHcc Risk Adjustment Specialist
CredentialsTypically requires a bachelor’s degree, industry certifications (e.g., CPC, CCS), and experience in healthcare or risk adjustmentOften requires similar certifications and experience but may have less managerial responsibility
Work EnvironmentSupervises teams, manages projects, and collaborates with multiple departmentsFocuses on data analysis, coding, and risk adjustment tasks, often working independently or in small teams
Employer & Industry UsageCommonly employed by health plans, healthcare providers, and risk adjustment vendorsFound within similar organizations, often as a specialized role supporting risk adjustment processes

The main difference is that the Manager Hcc Risk Adjustment oversees teams and manages projects, while the Hcc Risk Adjustment Specialist focuses on technical tasks like data analysis and coding. Both roles require relevant certifications and industry experience, but the manager role involves leadership responsibilities.

What are the key skills and qualifications needed to thrive as a Manager HCC Risk Adjustment, and why are they important?

To thrive as a Manager HCC Risk Adjustment, you need expertise in healthcare coding (especially ICD-10), risk adjustment methodologies, and a background in health administration or a related field, often supported by a relevant degree and coding certifications like CRC or CPC. Familiarity with risk adjustment analytics platforms, EHR systems, and healthcare data reporting tools is important. Strong leadership, analytical thinking, and effective communication skills enable you to guide teams and collaborate across departments. These skills and qualifications are essential to ensure accurate risk scoring, regulatory compliance, and optimal reimbursement for healthcare organizations.

How does a Manager HCC Risk Adjustment typically collaborate with other departments to ensure accurate risk scoring?

A Manager HCC Risk Adjustment frequently partners with coding teams, clinical staff, and data analysts to ensure that documentation and coding accurately reflect patient conditions for risk adjustment purposes. This collaboration often involves leading training sessions, reviewing charts for compliance, and coordinating audits to identify documentation gaps. Working closely with these departments helps ensure data integrity, optimize risk scores, and support organizational goals related to reimbursement and quality reporting.

What are Manager HCC Risk Adjustment jobs?

Manager HCC Risk Adjustment jobs involve overseeing teams and processes that assess and improve Hierarchical Condition Category (HCC) coding and risk adjustment in healthcare organizations. These managers ensure accurate documentation and coding of patient diagnoses to optimize reimbursement and compliance with government regulations. They collaborate with coders, clinicians, and data analysts to monitor performance, provide training, and implement best practices. Their role is critical in maximizing risk-adjusted revenue while maintaining high standards of patient data integrity.
What are the most commonly searched types of Hcc Risk Adjustment jobs in California? The most popular types of Hcc Risk Adjustment jobs in California are:
What are popular job titles related to Manager Hcc Risk Adjustment jobs in California? For Manager Hcc Risk Adjustment jobs in California, the most frequently searched job titles are:
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What cities in California are hiring for Manager Hcc Risk Adjustment jobs? Cities in California with the most Manager Hcc Risk Adjustment job openings:
Manager Hcc Risk Adjustment jobs near you
Infographic showing various Manager Hcc Risk Adjustment job openings in California as of July 2026, with employment types broken down into 95% Full Time, and 5% Contract. Highlights an 81% In-person, and 19% Remote job distribution.
HEALTH CODER - HCC & RISK ADJUSTMENT

HEALTH CODER - HCC & RISK ADJUSTMENT

NORTH EAST MEDICAL SERVICES

Burlingame, CA • Remote

$42.79 - $48.75/hr

Other

Posted 2 hours ago

Job description

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization’s quality outcomes and financial performance.

ESSENTIAL JOB FUNCTIONS:

  • HCC Coding and Risk Adjustment (RA) Program Support
    • Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
    • Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
    • Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
  • Provider Training and Clinical Documentation Improvement (CDI)
  • Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
  • Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
  • Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
  • Data Analysis and Reporting
    • Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
    • Generate reports and dashboards to track coding performance and documentation accuracy.
    • Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
  • Compliance and Continuous Improvement
    • Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
    • Assist in the development and implementation of internal coding policies and procedures.
    • Participate in quality improvement initiatives related to coding and documentation.
    • Performs other job duties as required by manager/supervisor
  • Education & Certification:
    • BS/BA Degree in Health Science or General Education is required. 
    • Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
    • Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
  • Experience:
    • Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
    • Experience in provider education, clinical documentation improvement (CDI), and chart audits.
    • Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
  • Skills & Competencies:
    • Excellent communication, presentation, and interpersonal skills.
    • Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
    • Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
    • Proficiency in electronic health records (EHR) and coding software.
    • Strong analytical and problem-solving skills.

LANGUAGE:

  • Must be able to fluently speak, read and write English.
  • Fluency in other languages is an asset.

STATUS:

  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This a full-time position. 

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