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Manager Hcc Risk Adjustment Jobs (NOW HIRING)

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

PedIM Healthcare

HCC Coder

Lecanto, FL

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

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Manager Hcc Risk Adjustment information

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$23K

$61.4K

$102.5K

How much do manager hcc risk adjustment jobs pay per year?

As of Jul 13, 2026, the average yearly pay for manager hcc risk adjustment in the United States is $61,351.00, according to ZipRecruiter salary data. Most workers in this role earn between $44,000.00 and $69,000.00 per year, depending on experience, location, and employer.

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.
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Manager Hcc Risk Adjustment jobs near you
Infographic showing various Manager Hcc Risk Adjustment job openings in the United States as of July 2026, with employment types broken down into 95% Full Time, and 5% Contract. Highlights an 76% In-person, and 24% Remote job distribution, with an average salary of $61,351 per year, or $29.5 per hour.
Manager, Risk Adjustment Quality Assurance

Manager, Risk Adjustment Quality Assurance

Millennium Physician Group

Florida, NY • On-site

Full-time

Re-posted 4 days ago

Millennium Physician Group rating

6.3

Company rating: 6.3 out of 10

Based on 62 frontline employees who took The Breakroom Quiz

668th of 882 rated healthcare providers

Job description

Job Description Summary

Position Summary
The Manager of Burden of Illness Quality Assurance oversees the prospective, concurrent, and retrospective risk adjustment internal audit and education functions. This role provides strategic and operational leadership for teams responsible for auditing HCC capture, clinical validation, and documentation compliance across the full risk adjustment lifecycle. The Manager ensures consistent audit methodology, regulatory compliance, staff development, and performance improvement, while serving as a subject-matter leader for CMS and HHS risk adjustment models.

How will you make an impact & Requirements

Key Responsibilities

Leadership & Team Management

  • Directly manage and develop internal auditors and educators supporting prospective, concurrent, and retrospective risk adjustment workflows.
  • Establish standardized audit frameworks, scoring methodologies, and inter-rater reliability processes across all review types.
  • Set performance expectations, conduct evaluations, and implement competency and career development plans.
  • Lead hiring, onboarding, training, and succession planning for audit and education staff.

Education & Program Development

  • Oversee prospective chart scrub audits, concurrent HCC validation and gap capture audits, and retrospective rejection/validation audits.
  • Ensure audits align with CMS risk adjustment regulations, ICD-10-CM Official Guidelines, and organizational compliance standards.
  • Develop and maintain audit policies, procedures, and quality assurance programs.

Quality Improvement

  • Establish KPIs and dashboards for prospective, concurrent, and retrospective audit programs.
  • Analyze trends in missed HCCs, unsupported diagnoses, rejection rates, and documentation gaps.
  • Drive continuous improvement initiatives to enhance accuracy, completeness, and financial integrity.

Qualifications

Required

  • Bachelor's degree or equivalent work experience
  • Active credential: CRC, CPC, CPMA, or similar certification
  • 5+ years of risk adjustment coding and/or auditing experience
  • Strong knowledge of CMS-HCC models, ICD-10-CM, MEAT, and audit methodology
  • Experience providing education or training to internal coding teams
  • Excellent written and verbal communication skills
  • Strong analytical and reporting skills
  • Ability to work independently in a fast-paced, cross-functional environment

Key Competencies

  • Regulatory and compliance expertise
  • Attention to detail and critical thinking
  • Professional communication and presentation skills
  • Ability to translate complex coding rules into practical guidance
  • Collaborative, consultative approach

Key Responsibilities

Leadership & Team Management

  • Directly manage and develop internal auditors and educators supporting prospective, concurrent, and retrospective risk adjustment workflows.
  • Establish standardized audit frameworks, scoring methodologies, and inter-rater reliability processes across all review types.
  • Set performance expectations, conduct evaluations, and implement competency and career development plans.
  • Lead hiring, onboarding, training, and succession planning for audit and education staff.

Education & Program Development

  • Oversee prospective chart scrub audits, concurrent HCC validation and gap capture audits, and retrospective rejection/validation audits.
  • Ensure audits align with CMS risk adjustment regulations, ICD-10-CM Official Guidelines, and organizational compliance standards.
  • Develop and maintain audit policies, procedures, and quality assurance programs.

Quality Improvement

  • Establish KPIs and dashboards for prospective, concurrent, and retrospective audit programs.
  • Analyze trends in missed HCCs, unsupported diagnoses, rejection rates, and documentation gaps.
  • Drive continuous improvement initiatives to enhance accuracy, completeness, and financial integrity.

Qualifications

Required

  • Bachelor's degree or equivalent work experience
  • Active credential: CRC, CPC, CPMA, or similar certification
  • 5+ years of risk adjustment coding and/or auditing experience
  • Strong knowledge of CMS-HCC models, ICD-10-CM, MEAT, and audit methodology
  • Experience providing education or training to internal coding teams
  • Excellent written and verbal communication skills
  • Strong analytical and reporting skills
  • Ability to work independently in a fast-paced, cross-functional environment

Key Competencies

  • Regulatory and compliance expertise
  • Attention to detail and critical thinking
  • Professional communication and presentation skills
  • Ability to translate complex coding rules into practical guidance
  • Collaborative, consultative approach

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