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Manager Hcc Risk Adjustment Jobs in California (NOW HIRING)

Astiva Health

Healthcare Data Analyst

Orange, CA

$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 ...

UCLA Health

Coding Supervisor

Los Angeles, CA · Remote

$65K - $130K/yr

Bachelor's degree in Health Information Management, healthcare administration, or related field, or ... are Compliance), HCC (Risk Adjustment Coding Certification) or Specialty Certification

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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:
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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.
Certified Coder (Risk Adjustment Experience) - REMOTE

Certified Coder (Risk Adjustment Experience) - REMOTE

Molina Healthcare

Long Beach, CA • Remote

$24.50 - $33.50/hr

Full-time

Posted 6 days ago

Molina Healthcare rating

8.1

Company rating: 8.1 out of 10

Based on 193 frontline employees who took The Breakroom Quiz

133rd of 281 rated insurance

Job description

JOB DESCRIPTION Job SummaryProvides support for medical coding activities, including ensuring that ICD-10 and CPT codes are reported accurately to maintain compliance, and minimize risk and denials. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
Performs on-going member medical chart reviews. Abstracts and reports ICD-10 and CPT diagnosis codes accurately and in compliance with established coding and billing principles - minimizing risk and denials.
Demonstrates understanding of current provider office billing practices - ensuring that diagnosis and CPT codes are submitted accurately.
Documents results/findings from chart reviews and provides feedback to leadership, providers and office staff.
Provides training and education to provider network regarding risk adjustment and coding updates related to risk adjustment.
Builds positive relationships between providers and the business by providing coding assistance as needed.
Facilitates administrative duties such as planning, chart reviews scheduling, medical records procurement, provider training and education.
Assists in coordination of management activities with other departments including finance, revenue analytics, claims, encounters and enterprise/plan medical directors.
Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks and participating in professional societies related to medical coding in the managed care industry.
Required Qualifications At least 2 years medical coding experience, or equivalent combination of relevant education and experience.
Certified Professional Coder (CPC).
Certified Coding Specialist (CCS).
Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge.
Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
Ability to effectively interface with staff, clinicians, and management.
Excellent verbal and written communication skills.
Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and all other customers.
Strong verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
Certified Risk Adjustment Coder (CRC).
Certified Professional Payer - Payer (CPC-P).
Certified Coding Specialist - Physician Based (CCS-P).
Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model.
Background in supporting risk adjustment management activities and clinical informatics.
Experience with risk adjustment data validation.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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