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Medicare Risk Adjustment Provider Educator Jobs

Medix

Risk Adjustment Director

Scotts Valley, CA · On-site

$96.15 - $120.19/hr

Oversee Medicare DSNP Risk Adjustment strategy and execution. * Directly support key operational ... Minimum Education and Experience Qualification Requirements Education * Bachelor's degree in ...

BHC ISC

PBO Risk Adjustment Coding

Fort Lauderdale, FL · On-site

... Medicare Advantage plans suspect HCC condition forms prior to submission to the payer. Education: High School or Equivalent Experience: 2-5 years of risk adjustment coding E/M procedures and ...

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Medicare Risk Adjustment Provider Educator information

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How much do medicare risk adjustment provider educator jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for medicare risk adjustment provider educator in the United States is $43.95, according to ZipRecruiter salary data. Most workers in this role earn between $33.65 and $52.40 per hour, depending on experience, location, and employer.

What is a Medicare Risk Adjustment Provider Educator?

Medicare Risk Adjustment Provider Educators are professionals who train healthcare providers on accurately documenting and coding patient diagnoses for Medicare risk adjustment purposes. Their main goal is to ensure that providers understand the importance of thorough and precise medical record documentation, which directly impacts Medicare payments and compliance. They often lead educational sessions, review documentation practices, and provide ongoing support to help providers meet regulatory standards. By doing so, they help healthcare organizations receive appropriate reimbursement and improve patient care quality.

What are the key skills and qualifications needed to thrive as a Medicare Risk Adjustment Provider Educator?

To thrive as a Medicare Risk Adjustment Provider Educator, you need in-depth knowledge of risk adjustment coding, Medicare guidelines, and clinical documentation, usually supported by a relevant healthcare degree and certifications like CPC, CRC, or CCS-P. Familiarity with coding software, EMR systems, and data analytics tools is essential for analyzing records and providing effective education. Strong communication, presentation, and relationship-building skills distinguish top performers in this role. These abilities ensure accurate coding, regulatory compliance, and improved provider understanding, which are critical for optimizing reimbursement and reducing audit risk.

How does a Medicare Risk Adjustment Provider Educator typically collaborate with healthcare providers and coding teams?

A Medicare Risk Adjustment Provider Educator works closely with healthcare providers and coding teams to ensure accurate documentation and coding of diagnoses for risk adjustment purposes. They often conduct training sessions, provide feedback on documentation practices, and clarify coding guidelines to both individual clinicians and group practices. Regular collaboration may involve joint chart reviews, educational workshops, and ongoing communication to address documentation gaps or regulatory updates. This role requires strong interpersonal skills and an ability to translate complex regulatory information into practical guidance for busy clinical teams.

What is the difference between Medicare Risk Adjustment Provider Educator vs Medicare Risk Adjustment Analyst?

AspectMedicare Risk Adjustment Provider EducatorMedicare Risk Adjustment Analyst
CredentialsTypically requires healthcare certifications, training in risk adjustment, and teaching experienceRequires healthcare or data analysis certifications, proficiency in data tools, and risk modeling knowledge
Work EnvironmentEducational settings, provider offices, or training programsData analysis departments, healthcare organizations, or insurance companies
Employer & Industry UsageHospitals, health plans, and training organizationsInsurance companies, healthcare analytics firms, and health plans

The Medicare Risk Adjustment Provider Educator focuses on training healthcare providers on risk adjustment processes, while the Medicare Risk Adjustment Analyst analyzes data to optimize risk scores. Both roles require healthcare knowledge but differ in their primary functions and work environments.

What are popular job titles related to Medicare Risk Adjustment Provider Educator jobs?

For Medicare Risk Adjustment Provider Educator jobs, the most frequently searched job titles are:

Infographic showing various Medicare Risk Adjustment Provider Educator job openings in the United States as of September 2026, with employment types broken down into 75% Full Time, and 25% Part Time. Highlights an 50% In-person, 25% Hybrid, and 25% Remote job distribution, with an average salary of $91,418 per year, or $44 per hour.

Risk Adjustment Director

Scotts Valley, CA • On-site

Medix
Recruiting and Staffing Services • 1 - 5K employees
Learn more about Medixexternal

$96.15 - $120.19/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 16 days ago

Job description

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a skilled Risk Adjustment Director to serve as the executive strategic leader and subject matter expert for the health plan's Risk Adjustment Department. The primary responsibilities include designing and overseeing data strategies to ensure accurate member health coding, managing financial impacts of risk scores, leading a team, and acting on behalf of the CFO when necessary.
Responsibilities / Job Duties
  • Build the roadmap for the health plan's risk adjustment goals to improve data collection, reporting, and auditing.
  • Track risk scores and work closely with Actuaries and Financial Planning & Analysis to align with budgets.
  • Optimize Risk Adjustment Factor improvements through external vendors.
  • Partner with the Provider Relations Director to train and support doctors on compliant, accurate medical record coding.
  • Hire, train, mentor, and evaluate a team of risk adjustment professionals.
  • Formulate and manage the Risk Adjustment Department's operational budget.
  • Oversee Medicare DSNP Risk Adjustment strategy and execution.
  • Directly support key operational initiatives to ensure program stability and scalability.

Minimum Education and Experience Qualification Requirements
Education
  • Bachelor's degree in Finance, Business, Healthcare Administration, Mathematics, Statistics, or a closely related field.

Qualifications
  • 10 years of experience in healthcare finance or analytics.
  • 5 years of experience with Medicare risk adjustment processes.
  • 2 years of experience related to 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.
  • Familiarity with data analytical tools like SQL and visualization platforms like Tableau.

Skills
  • Technical proficiency in data analytical tools and coding methodologies.
  • Strong leadership and team management skills.
  • Excellent communication and organizational abilities.

Schedule / Shift
Mon-Fri 8am-5pm (potential for some flexibility for early/later start upon discussion)
Benefits
  • Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
  • Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
  • 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
  • Short Term Disability Insurance.
  • Term Life Insurance Plan.

Required Employment / Compliance Language
Medix is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex
* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
* As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients
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About Medix Staffing Solutions

Sourced by ZipRecruiter

Since 2001, we’ve been dedicated to helping you achieve your goals. Medix was created to become a leading provider of workforce solutions for clients and candidates across the healthcare and life sciences industries. Today, we are that leader. Headquartered in Chicago, we have 23 offices across the United States, and staff talent around the world. Medix is committed to fulfilling our core purpose as an organization: to positively impact the lives of our talent, clients, and teammates through employment, philanthropy, and opportunity. The combination of purpose and values has nurtured our thriving culture that encourages our internal team to excel at work and in everyday life.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Chicago, IL, US

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