... Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities. * Assess ... Conduct compliance risk assessments related to coding, documentation, and encounter data ...
... Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities. * Assess ... Conduct compliance risk assessments related to coding, documentation, and encounter data ...
Clinical Compliance Manager
Tempe, AZ · Hybrid
Drive and support compliance risk assessments, as well as work plan development and implementation ... Minimum of five (5) years of experience in Medicare Managed Care, with preferred expertise in ...
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Clinical Compliance Manager
Tempe, AZ · Hybrid
Drive and support compliance risk assessments, as well as work plan development and implementation ... Minimum of five (5) years of experience in Medicare Managed Care, with preferred expertise in ...
GRANTS COORDINATOR
Phoenix, AZ · On-site +1
$43K - $70K/yr
The Grant Compliance Specialist performs risk assessments, plans and conducts desk reviews and on ... Arizona's Rural Health Transformation Program is supported by the Centers for Medicare & Medicaid ...
GRANTS COORDINATOR
Phoenix, AZ · On-site +1
$43K - $70K/yr
The Grant Compliance Specialist performs risk assessments, plans and conducts desk reviews and on ... Arizona's Rural Health Transformation Program is supported by the Centers for Medicare & Medicaid ...
Job Page
Phoenix, AZ · On-site
$43K - $70K/yr
The Grant Compliance Specialist performs risk assessments, plans and conducts desk reviews and on ... Arizona's Rural Health Transformation Program is supported by the Centers for Medicare & Medicaid ...
Job Page
Phoenix, AZ · On-site
$43K - $70K/yr
The Grant Compliance Specialist performs risk assessments, plans and conducts desk reviews and on ... Arizona's Rural Health Transformation Program is supported by the Centers for Medicare & Medicaid ...
GRANTS COORDINATOR
Phoenix, AZ · On-site +1
$43K - $70K/yr
The Grant Compliance Specialist performs risk assessments, plans and conducts desk reviews and on ... Arizona's Rural Health Transformation Program is supported by the Centers for Medicare & Medicaid ...
GRANTS COORDINATOR
Phoenix, AZ · On-site +1
$43K - $70K/yr
The Grant Compliance Specialist performs risk assessments, plans and conducts desk reviews and on ... Arizona's Rural Health Transformation Program is supported by the Centers for Medicare & Medicaid ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
General Physician Assistant job in Phoenix AZ
$99K - $134K/yr
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
General Physician Assistant job in Phoenix AZ
$99K - $134K/yr
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
Nurse Practitioner - Primary Care Outpatient - Phoenix, Arizona
Phoenix, AZ · On-site
$101K - $139K/yr
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require a holistic view of health and a ...
Nurse Practitioner - Primary Care Outpatient - Phoenix, Arizona
Phoenix, AZ · On-site
$101K - $139K/yr
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require a holistic view of health and a ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... Medicare Advantage, and Medicaid arrangements. Operating as a peer Director within the Payor ... analysis, and downside risk assessment.Performance Monitoring & Optimization:Lead post ...
... Medicare Advantage, and Medicaid arrangements. Operating as a peer Director within the Payor ... analysis, and downside risk assessment.Performance Monitoring & Optimization:Lead post ...
... Medicare Advantage, and Medicaid arrangements. Operating as a peer Director within the Payor ... downside risk assessment. Performance Monitoring & Optimization: Lead post implementation ...
... Medicare Advantage, and Medicaid arrangements. Operating as a peer Director within the Payor ... downside risk assessment. Performance Monitoring & Optimization: Lead post implementation ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
General Physician Assistant job in Tucson AZ
$94K - $128K/yr
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
General Physician Assistant job in Tucson AZ
$94K - $128K/yr
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
General Physician Assistant job in Tucson AZ
$94K - $128K/yr
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
General Physician Assistant job in Tucson AZ
$94K - $128K/yr
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require aholistic view of health and ...
Bi-lingual Nurse Practitioner - Primary Care Outpatient - Tucson, Arizona
Tucson, AZ · On-site
$106K - $135K/yr
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require a holistic view of health and a ...
Bi-lingual Nurse Practitioner - Primary Care Outpatient - Tucson, Arizona
Tucson, AZ · On-site
$106K - $135K/yr
... on Medicare, with the goal of keeping patients healthy and living life to the fullest - Administer Annual wellness visits and health risk assessments, which require a holistic view of health and a ...
Medicare Risk Assessment information
See Arizona salary details
$21.53 is the 25th percentile. Wages below this are outliers.
$18.59 - $22.63
34% of jobs
The median wage is $25.15 / hr.
$22.63 - $26.66
25% of jobs
$26.66 - $30.69
0% of jobs
$30.69 - $34.72
0% of jobs
$34.72 - $38.75
6% of jobs
$38.75 - $42.79
2% of jobs
$42.79 - $46.82
5% of jobs
$48.16 is the 75th percentile. Wages above this are outliers.
$46.82 - $50.85
6% of jobs
$50.85 - $54.88
8% of jobs
$54.88 - $58.91
10% of jobs
$58.91 - $62.95
2% of jobs
$18
$36
$62
How much do medicare risk assessment jobs pay per hour?
As of Jul 28, 2026, the average hourly pay for medicare risk assessment in Arizona is $36.05, according to ZipRecruiter salary data. Most workers in this role earn between $22.16 and $50.62 per hour, depending on experience, location, and employer.
What is a Medicare Risk Assessment job?
A Medicare Risk Assessment job involves evaluating patients' health conditions to determine risk scores that impact Medicare Advantage plan reimbursements. Professionals in this role collect and analyze medical data, review patient histories, and ensure accurate coding of diagnoses. Their work helps healthcare providers and insurers understand patient risks and deliver appropriate care. Strong knowledge of ICD-10 coding, healthcare regulations, and medical terminology is essential for this role.
What are some common challenges faced in a Medicare Risk Assessment role?
One common challenge in Medicare Risk Assessment is staying up to date with frequently changing Medicare regulations and coding requirements, which directly affect risk scoring and patient documentation. Handling large volumes of patient data while ensuring accuracy and compliance can also be demanding, as errors may impact reimbursement and care outcomes. Collaboration with clinicians, billing teams, and administrators is often necessary to clarify complex cases and ensure complete, compliant documentation. Successfully navigating these challenges requires ongoing learning, keen attention to detail, and effective communication skills.
What are the key skills and qualifications needed to thrive in the Medicare Risk Assessment position, and why are they important?
To thrive in a Medicare Risk Assessment role, you need a strong understanding of healthcare regulations, Medicare guidelines, data analysis, and clinical assessment—often supported by a background in nursing, healthcare administration, or a related field. Proficiency with health risk assessment tools, electronic health records (EHRs), and data management systems is important, and certification such as Certified Risk Adjustment Coder (CRC) can be beneficial. Attention to detail, analytical thinking, and effective communication stand out as key soft skills in this position. These skills are crucial for accurately evaluating patient risk, ensuring compliance, and supporting optimal Medicare plan outcomes.
What are popular job titles related to Medicare Risk Assessment jobs in Arizona? For Medicare Risk Assessment jobs in Arizona, the most frequently searched job titles are:
What job categories do people searching Medicare Risk Assessment jobs in Arizona look for? The top searched job categories for Medicare Risk Assessment jobs in Arizona are:
- Remote Oasis Review
- Remote Qualified Medical Evaluator
- Remote International Psychiatry
- Remote Chart Auditing
- No Experience Rhia
- Work From Home Certified Radiology Coder
- Remote Trillium Health Care Products
- Remote R1 Rcm Medical Coding
- Remote Director Of Clinical Education
- Night Shift Remote Medical Records Retrieval
What cities in Arizona are hiring for Medicare Risk Assessment jobs? Cities in Arizona with the most Medicare Risk Assessment job openings:
$75K - $165K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 6 days ago
CVS Health rating
5.8
Based on 4,319 frontline employees who took The Breakroom Quiz
88th of 109 rated pharmacies
Job description
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position Summary
As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.
The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.
Key Responsibilities
Lead the Medicare Advantage Risk Adjustment compliance program.
Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.
Assess operational processes for compliance risks related to risk adjustment activities.
Develop and implement corrective action plans for identified compliance issues.
Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.
Required Qualifications
Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance
Minimum 5 years in a leadership role
One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)
Willingness to travel up to 10% (including by plane)
Preferred Qualifications
Health Information Management (RHIA/RHIT)
Nursing - Strong understanding of clinical documentation and medical record review
Certified Risk Adjustment Coder (CRC) with compliance experience
Provider coding audit/compliance leadership experience
Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits
Education
Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.
Pay Range
The typical pay range for this role is:
$75,400.00 - $165,954.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Benefits
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About CVS Health
Sourced by ZipRecruiter
Industry
Health care and social assistance and retail
Company size
10,000+ Employees
Headquarters location
Woonsocket, RI, US