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Medicare Risk Adjustment Jobs in Arkansas (NOW HIRING)

Nutex Health

Support chart review and documentation collection for HEDIS, RAF, and risk adjustment programs ... Experience with Medicare Advantage and/or Medicaid quality programs. * Experience working with ...

All JobsMedicare Risk Adjustment JobsMedicare Risk Adjustment Jobs in Arkansas

Medicare Risk Adjustment information

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$10

$18

$33

How much do medicare risk adjustment jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for medicare risk adjustment in Arkansas is $18.54, according to ZipRecruiter salary data. Most workers in this role earn between $13.32 and $22.45 per hour, depending on experience, location, and employer.

What is Medicare Risk Adjustment?

Medicare Risk Adjustment is a process used by the Centers for Medicare & Medicaid Services (CMS) to adjust payments to Medicare Advantage plans based on the health status and demographic characteristics of their enrolled beneficiaries. The goal is to ensure that plans receive appropriate compensation for taking care of members with varying levels of health risk. This system uses diagnosis codes and other data to predict future healthcare costs, encouraging plans to provide comprehensive care and accurately document patient conditions.

What are jobs in Medicare Risk Adjustment?

Jobs in Medicare risk adjustment include work in data analytics, consulting, insurance, and closely related industries. Your duties and responsibilities differ depending on the type of work. For example, as a Medicare risk-adjustment consultant, you provide advice and recommendations to healthcare organizations or an insurance provider on how to mitigate risk across a customer pool. Data analytics and statistics specialists gather and analyze insurance and Medicare data and documentation from hospitals, healthcare providers, and other medical care facilities that accept Medicare. This includes reviewing different types of diagnosis and comparing patient chart information. Some health care providers have in-house risk adjustment workers, while others contract with outside consulting and analytics firms.

What are the key skills and qualifications needed to thrive in Medicare Risk Adjustment?

To excel in Medicare Risk Adjustment, you need a solid understanding of medical coding (especially ICD-10), healthcare regulations, and risk adjustment methodologies, often supported by credentials like CRC or CPC certifications. Familiarity with data analytics platforms, EHR systems, and specialized risk adjustment software is typically required. Strong attention to detail, analytical thinking, and effective communication are crucial soft skills for interpreting complex clinical data and collaborating across teams. These competencies ensure accurate risk scores, compliance with CMS requirements, and optimal financial outcomes for healthcare organizations.

What are some common challenges faced by professionals working in Medicare Risk Adjustment roles?

Professionals in Medicare Risk Adjustment often encounter challenges such as staying current with frequently changing CMS regulations, ensuring the accurate capture and documentation of patient diagnoses, and collaborating effectively with providers to optimize risk scores. The role requires meticulous attention to detail when reviewing medical records and coding, as well as strong communication skills to educate and support healthcare teams. Additionally, there can be pressure to meet strict deadlines for data submission and to ensure compliance with audit standards.

What is the difference between Medicare Risk Adjustment vs Medicare Coding Specialist?

AspectMedicare Risk AdjustmentMedicare Coding Specialist
Primary FocusAssessing patient health risk scores for reimbursementAccurately coding medical diagnoses and procedures
Required CredentialsCertifications in risk adjustment or coding, often CPC or RHITCertifications like CPC, CCS, or RHIT
Work EnvironmentHealth plans, risk adjustment companies, healthcare providersHospitals, clinics, billing departments
Industry UsageUsed for Medicare Advantage plan reimbursementsUsed for medical billing and claims processing

While both roles involve healthcare coding and require similar certifications, Medicare Risk Adjustment focuses on evaluating patient health data to determine reimbursement levels, whereas Medicare Coding Specialists concentrate on accurately coding diagnoses and procedures for billing purposes.

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What are popular job titles related to Medicare Risk Adjustment jobs in Arkansas?

For Medicare Risk Adjustment jobs in Arkansas, the most frequently searched job titles are:

What job categories do people searching Medicare Risk Adjustment jobs in Arkansas look for?

The top searched job categories for Medicare Risk Adjustment jobs in Arkansas are:

Medicare Risk Adjustment jobs near you
Infographic showing various Medicare Risk Adjustment job openings in Arkansas as of August 2026, with employment types broken down into 1% As Needed, 89% Full Time, 8% Part Time, and 2% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $38,561 per year, or $18.5 per hour.

Field Nurse Practitioner - Benton County, Arkansas

Advantmed

Bentonville, AR • On-site

$137.76/hr

Other

Re-posted 15 days ago

Job description

About Advantmed

Advantmed is a leading provider of risk adjustment, quality improvement and value-based solutions to health plans and providers. We drive market leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance, and the proactive clinical engagement of high acuity populations.

Primary Purpose

We are proud of the quality care we provide members, and our team is rapidly expanding to meet the demands of our growing business; we are seeking a highly skilled and compassionate certified Nurse Practitioner to join our Advantmed provider network.

In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare members and other at-risk populations. Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care. This role is 1099 (PRN) and offers tremendous flexibility and opportunity for those who are balancing competing priorities.

NP Responsibilities

In-home Clinical Assessments

  • Travel to members’ homes and conduct comprehensive health evaluations
  • Conduct Annual Wellness Visits and health assessments for members with chronic conditions

Perform:

  • Medical history and physical examinations
  • Review of systems
  • Vital signs collection
  • Medication review and reconciliation
  • Possible preventive health screenings
  • Hemoglobin A1C
  • Spirometry
  • KED (Kidney Health Evaluation)
  • DRE (Diabetic Retinal Exam)
  • FIT

Patient Education & Engagement

  • Deliver preventive health education and counseling opportunities
  • Educate patients on ongoing health monitoring, medication adherence, and chronic condition management
  • Support informed decision-making and ensure true, informed consent
  • Engage in goal of care discussions when appropriate

Care Coordination & Quality Support

  • Identify clinically relevant diagnoses for care management and risk adjustment documentation
  • Communicate findings used to generate post-visit summaries for the primary care provider
  • Identify and help close quality care gaps (e.g., screenings, labs, follow-ups)
  • Collaborate enthusiastically with the broader care team to enhance clinical quality and patient experience

Compliance & Professional Standards

  • Adhere to HIPAA regulations and safeguard protected health information (PHI)
  • Maintain accurate, timely, and compliant EMR documentation
  • Perform additional duties as assigned in alignment with organizational goals
  • An enthusiastic collaborator contributing to the enhancement of care delivery
  • Providers are expected to commit a minimum of 30 hours per month
Locations
  • Benton County, Arkansas
Travel Requirements
  • Daily travel expectations remain within a 55-mile radius of the assigned homelocation
NP Qualifications
  • Must have a valid, unencumbered NP License for the state you will be working in
  • This role requires travel up to a maximum 55-mile radius originating in the assigned job posting county
  • Preference is given to weekday schedules
  • Preference is given to standard working hour schedules
  • Previous in-home risk assessment experience preferred
  • Previous 1099 (PRN) experience is preferred but not required
  • 3 years patient care experience preferred (primary care/adult/geriatric, EMR)
  • May be requested to obtain additional NP licensure supported by Advantmed
  • Access to reliable transportation that will enable you to travel to members’ homes within a designated area
  • Strong ability to work within our EMR system
  • Ability to work independently
  • Bilingual is a plus
Advantmed Offers
  • Competitive compensation of ~$100 per completed in-home health assessment
  • Paid mileage
  • Flexible work schedule, choose your own schedule
  • Noon call
  • Visits ready to be scheduled immediately
  • Appointment confirmation support
  • Dedicated coordinator support
  • Advanced member scheduling coverage
  • State of art technology
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