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Manager Hcc Risk Adjustment Jobs in Texas (NOW HIRING)

Altegra Health

Remote Certified Coder

Dallas, TX · Remote

$22.25 - $30.50/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Strong clinical skills related to chronic illness diagnosis, treatment and management; Reliability ...

Altegra Health

Remote Certified Coder

Dallas, TX · On-site +1

$22.25 - $30.50/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Manager of Clinical Operations. • Comply with the Standards of Ethical Coding as set forth by the ...

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82K - $108K/yr

You will work with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs. You will report into the Manager, Risk Adjustment. Work Location: This is a ...

CommonSpirit Health

Value Based Coder II

Houston, TX

$18 - $23.75/hr

... as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC ... Ability to manage multiple priorities and work independently. Computer literacy in medical ...

St. Luke's Health

Value Based Coder II

Houston, TX · On-site +1

$25.30 - $35.74/hr

... Management/Risk team, responsible for independently reviewing patient medical records to identify ... as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC ...

St Luke's Health

Value Based Coder II

Houston, TX

$25.30 - $35.74/hr

... Management/Risk team, responsible for independently reviewing patient medical records to identify ... as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC ...

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All JobsManager Hcc Risk Adjustment JobsManager Hcc Risk Adjustment Jobs in Texas

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 Texas? The most popular types of Hcc Risk Adjustment jobs in Texas are:
What are popular job titles related to Manager Hcc Risk Adjustment jobs in Texas? For Manager Hcc Risk Adjustment jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Manager Hcc Risk Adjustment jobs in Texas look for? The top searched job categories for Manager Hcc Risk Adjustment jobs in Texas are:
What cities in Texas are hiring for Manager Hcc Risk Adjustment jobs? Cities in Texas 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 Texas as of June 2026, with employment types broken down into 96% Full Time, and 4% Contract. Highlights an 77% In-person, and 23% Remote job distribution.

Risk Adjustment Coding Specialist II - Houston, Texas

Astrana Health, Inc.

Houston, TX • On-site

$70K - $85K/yr

Full-time

Posted 4 days ago

Job description

Risk Adjustment Coding Specialist II - Houston, Texas
Department: Quality - Risk Adjustment
Employment Type: Full Time
Location: 19500 HWY 249, Suite 570 Houston, TX 77070
Reporting To: Chanell Graves
Compensation: $70,000 - $85,000 / year
Description
We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Beaumont market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You'll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you'll track and report on key performance metrics-such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success.
We are seeking candidates who have experience with provider education and at least 3-5 years of risk adjustment experience! We are seeking candidates who reside in Houston and are able to travel to Beaumont on a monthly basis.
Our Values:
  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence
  • Be Innovative
  • Work As One Team

What You'll Do
  • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company
  • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC)
  • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines
  • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing
  • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
  • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives.
  • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work.
  • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager.
  • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I
  • Other duties as assigned

Qualifications
  • Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification - Certified Coding Specialist (CCS-P), CCS, or CPC.
  • 3-5+ years of experience in risk adjustment coding and/or billing experience required
  • Reliable transportation/Valid Driver's License/Must be able to travel up to 75% of work time
  • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
  • Excellent presentation, verbal and written communication skills, and ability to collaborate
  • Must possess the ability to educate and train provider office staff members
  • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.

You're great for this role if:
  • Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC
  • Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
  • Strong PowerPoint and public speaking experience
  • Ability to work independently and collaborate in a team setting
  • Experience with Monday.com
  • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting

Environmental Job Requirements and Working Conditions
  • The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
  • This role follows a hybridwork structure where the expectation is to work on the field and at home on a weekly basis. This position requires monthly travel to Beaumont from Houston.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.comto request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

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