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Medicare Risk Adjustment Jobs in Iowa (NOW HIRING)

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Medicare Risk Adjustment information

See Iowa salary details

$11

$21

$37

How much do medicare risk adjustment jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for medicare risk adjustment in Iowa is $21.06, according to ZipRecruiter salary data. Most workers in this role earn between $15.14 and $25.53 per hour, depending on experience, location, and employer.

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 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.

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 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 are the key skills and qualifications needed to thrive in Medicare Risk Adjustment, and why are they important?

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.
More about Medicare Risk Adjustment jobs
What are popular job titles related to Medicare Risk Adjustment jobs in Iowa? For Medicare Risk Adjustment jobs in Iowa, the most frequently searched job titles are:
What job categories do people searching Medicare Risk Adjustment jobs in Iowa look for? The top searched job categories for Medicare Risk Adjustment jobs in Iowa are:
Medicare Risk Adjustment jobs near you
Infographic showing various Medicare Risk Adjustment job openings in Iowa as of July 2026, with employment types broken down into 1% As Needed, 76% Full Time, 16% Part Time, and 7% Contract. Highlights an 90% Physical, 4% Hybrid, and 6% Remote job distribution, with an average salary of $43,800 per year, or $21.1 per hour.
Physician, Post Acute - Institutional Special Needs Plan (Las Vegas, NV)

Physician, Post Acute - Institutional Special Needs Plan (Las Vegas, NV)

CareMore Health

Nevada, IA

$96K - $131K/yr

Full-time

Posted 16 days ago

Job description

Job Description Summary

With nearly 30 years of experience in providing advanced primary care, CareMore Health delivers exceptional patient experiences. Compassionate clinicians take the time to understand each patient's unique health needs while also removing barriers to access. Patients trust us to receive the right personalized care where and when they need it - in our care centers, at home or virtually - to improve their health outcomes and quality of life.

How will you make an impact & Requirements

Sign-on Bonus: Primary Care Physician - ISNP (Institutional Special Needs Plan) Las Vegas, NV


The Primary Care Physician (PCP), ISNP is responsible for providing comprehensive, patient-centered primary care to a complex senior population enrolled in CareMore's Institutional Special Needs Plan (ISNP) program. This role partners closely with an interdisciplinary care team to deliver high-quality, value-based care with a focus on improving clinical outcomes, reducing avoidable hospitalizations, and supporting patients in long-term care (LTC), skilled nursing facilities (SNF), and other institutional settings.


The physician provides longitudinal care management, completes timely assessments, coordinates transitions of care, and supports CareMore's mission of improving the health and well-being of vulnerable populations through proactive and evidence-based care.


Key Responsibilities:


Clinical Care & Patient Management:

  • Deliver high-quality primary care services to ISNP members with complex

  • chronic conditions in institutional settings (e.g., SNF/LTC).

  • Conduct comprehensive patient assessments, including admission evaluations,

  • routine follow-ups, and acute visits as clinically indicated.

  • Develop and manage individualized care plans, including chronic disease

  • management and preventive care interventions.

  • Provide timely diagnosis and treatment while aligning with evidence-based

  • guidelines and CareMore clinical protocols.


Care Coordination & Transitions of Care

  • Coordinate care with nurses, care managers, social workers, specialists, facility

  • staff, and other interdisciplinary team members.

  • Manage transitions of care including post-acute follow-ups, hospital discharges,

  • readmission prevention, and medication reconciliation.

  • Collaborate with patients and families to support care goals, advanced care

  • planning, and health education.


Documentation & Compliance

  • Ensure accurate, thorough, and timely documentation in the electronic medical

  • record (EMR).

  • Complete required documentation supporting quality, risk adjustment, and

  • program compliance.

  • Follow all regulatory requirements and internal policies related to CMS, ISNP

  • standards, and institutional care.


Quality, Outcomes & Value-Based Care

  • Support achievement of clinical and quality outcomes including preventive

  • screenings, chronic disease measures, and patient experience.

  • Participate in initiatives aimed at reducing avoidable emergency department

  • visits, readmissions, and total cost of care.

  • Contribute to continuous improvement efforts through participation in clinical

  • reviews, team huddles, and process improvement work.

Professional Practice & Team Collaboration

  • Demonstrate clinical leadership and act as a trusted partner to the care team and

  • facility partners.

  • Participate in interdisciplinary case conferences, care planning meetings, and

  • clinical operations discussions as needed.

  • Maintain a culture of compassion, respect, accountability, and excellence in

  • patient care.

Minimum Qualifications:

  • MD or DO from an accredited medical school.

  • Completion of an accredited residency program in Family Medicine, Internal

  • Medicine, or Geriatrics (preferred)

  • Current, unrestricted medical license in the state of practice (or ability to obtain).

  • Board Certified or Board Eligible in Family Medicine or Internal Medicine.

  • DEA license

Preferred Qualifications

  • 2+ years of experience providing primary care to seniors and/or medically

  • complex populations.

  • Experience providing care in institutional settings such as Skilled Nursing

  • Facilities (SNF), Long-Term Care (LTC), Assisted Living or post-acute

  • environments

  • Knowledge of value-based care models, Medicare Advantage, HEDIS, Stars, and

  • risk adjustment/HCC documentation.

  • Comfort working collaboratively in a multidisciplinary care model.

  • Strong communication and relationship-building skills with patients, families, and

  • facility partners.


Work Environment & Physical Requirements
  • Primarily facility-based and/or field-based in institutional settings.
  • May require travel between assigned facilities and/or CareMore locations.

  • Ability to sit, stand, and walk throughout the workday and perform required

  • patient assessments.

  • Ability to work with standard office and clinical equipment.

Core Competencies

  • Patient-centered care with a commitment to service excellence

  • Clinical quality and evidence-based decision making

  • Strong collaboration and interdisciplinary teamwork

  • Accountability and integrity

  • Efficient documentation and attention to detail

  • Adaptability in a fast-paced healthcare environment

Compensation:

$211,369.00

to

$317,053.00

Apply