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Manager Hcc Risk Adjustment Jobs in Virginia (NOW HIRING)

Hirebridge

Risk Manager

Alexandria, VA · On-site

$119 - $130/hr

... necessary adjustments such as limit increases and policy extensions. * Oversee and maintain ... of Risk Management of any concerns. Conducts annual MVR audits and oversees tracking of personal ...

JOHNSON HEALTH CENTER

Coding Specialist

Madison Heights, VA · On-site

$17.25 - $21/hr

Reviews and captures Risk Adjustment/HCC diagnoses in accordance with CMS guidelines. * Monitors ... Management may modify, add, or remove any job functions as necessary, or as changing organizational ...

Tria Federal

Senior Product Analyst

Arlington, VA · On-site

Hands-onproficiencywith Jira, Confluence, and TestRail for backlog management, traceability, and ... CMS or Medicare Advantage / Part D risk adjustment domain knowledge; familiarity with encounter ...

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Manager Hcc Risk Adjustment information

What is a Manager HCC Risk Adjustment?

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 key skills and qualifications needed to thrive as a Manager HCC Risk Adjustment?

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 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 most commonly searched types of Hcc Risk Adjustment jobs in Virginia?

The most popular types of Hcc Risk Adjustment jobs in Virginia are:

What are popular job titles related to Manager Hcc Risk Adjustment jobs in Virginia?

For Manager Hcc Risk Adjustment jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Manager Hcc Risk Adjustment jobs in Virginia look for?

The top searched job categories for Manager Hcc Risk Adjustment jobs in Virginia are:

What cities in Virginia are hiring for Manager Hcc Risk Adjustment jobs?

Cities in Virginia 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 Virginia as of August 2026, with employment types broken down into 94% Full Time, and 6% Contract. Highlights an 74% In-person, and 26% Remote job distribution.

IPA Consultative Coder

CenterWell Primary Care

Suffolk, VA • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 9 days ago

Key responsibilities

  • Provide medical coding expertise and consultative support to IPA affiliates and their providers.

  • Support providers by analyzing coding trends, conducting quarterly chart reviews, and delivering targeted education to improve coding accuracy and documentation practices.

  • Assist with daily coding workflows, support internal coding tools, participate in real-time helpdesk support, and collaborate with leadership to identify and address coding gaps.

CenterWell rating

9.0

Company rating: 9.0 out of 10

Based on 10 frontline employees who took The Breakroom Quiz

Job description

Become a part of our caring community
Become a part of our caring community and help us put health first
*** $5,000 SIGN-ON BONUS for new associates! $5,000 payable following 90 days employment. ***
The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives.You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.
As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards,while collaborating with STARS leaders and champions to identify STARS gaps and deficiencies.
The IPA Consultative Coding Professional provides medical coding expertise to support IPA-affiliatedclinicians-including physicians and advanced practiceproviders-to ensure documentation supports accurate diagnostic coding and risk adjustment capture.

Relationship Management and Provider Support

  • Be the primary contact for assigned IPA providers for all coding and documentation-related inquiries.

  • Build consultative relationships with providers to support continuous improvement in coding accuracy and documentation practices.

  • Deliver targeted education based on provider-specific trends and opportunities identified through chart reviews and coding analytics.

Quarterly Chart Reviews and Education

  • Conduct quarterly chart reviews for assigned providers to evaluate coding accuracy, documentation integrity, and risk capture opportunities.

  • Develop and deliver comprehensive education based on findings, including documentation best practices and coding optimization strategies.

  • Identify trends and recurringgaps, andpartner with education and leadership teams to address systemic opportunities.

Coding Tools, Workflow Support, and Operations

  • Support daily operations of internal coding solutions, including Annual Proof of Documentation (APD 2.0) and any future tools implemented based on organizational needs.

  • Assist providers in navigating coding workflows, resolving issues, and ensuring successful use of coding tools.

  • Monitor and support completion of coding activities tied to assigned providers.

IPA Coding Helpdesk Support

  • Participate in a daily coder helpdesk (virtual/Zoom-based), providing real-time support to providers within assigned markets.

  • Address immediate coding and documentation questions, ensuring accurate guidance.

  • Maintain a high level of responsiveness and provider engagement.

HCC Outage and Recapture Support

  • Support HCC outage management through structured reviews of "assessed but not coded" conditions.

  • Conduct targeted reviews to identify missed coding opportunities and provide education to improve recapture performance.

  • Collaborate with analytics and leadership teams to track and improve performance outcomes.


Use your skills to make an impact

Required Qualifications:

  • 3+ years of risk adjustment MedicalCodingor riskadjustmentProviderEducation

  • Intermediate/advanced competency with MS Office based programs (Excel, Word, PowerPoint)

  • Must be certified at least one of the following: CCS, CRC, or CPC

  • Must resideand be able to travelwithin the assigned MSO market or region.

Preferred Qualifications:

  • Strong communication and interpersonal skills are essential. These skills enable effective, clear, and sensitive engagement with clinicians and team members, even in high-pressure or stressful situations. They also facilitate presenting, influencing, and building credibility at all levels of the organization.

  • Positive, collaborative mindset with an ability to foster partnerships across Coding, Audit and Education, PCO, and Humana teams.

Additional Information

  • We ask that youhave the ability totravel locally for in-office provider support.

  • Standard working hours required; based on market needs.

  • Travel may be required based on provider engagement and business needs.

Work Information:

This role requires an in-center presence, involving daily commute to assigned clinic(s) and occasional (quarterly) travel within the market to alternative clinic(s) for strategic meetings.

  • Workstyle: Hybrid/remote

  • Location:Must residewithin 50 milesof Chesapeake, Suffolk or Virginia Beach, Virginia

  • Hours:Monday-Friday, 8:00 AM-5:00 PM; additional time may be required.

TB Statement:

This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

Driving Statement:

This role is part of our company's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance.Individualmust carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

Work at Home Statement

To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

  • Satellite, cellular and microwave connection can be used only if approved by leadership.

  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

  • Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$59,300 - $80,900 per year


This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer atCenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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