Experience conducting compliance risk assessments, auditing, monitoring, investigations, and ... Experience within a health plan, managed care organization, HMO, Medicare Advantage plan, or payer ...
Experience conducting compliance risk assessments, auditing, monitoring, investigations, and ... Experience within a health plan, managed care organization, HMO, Medicare Advantage plan, or payer ...
Experience conducting compliance risk assessments, auditing, monitoring, investigations, and ... Experience within a health plan, managed care organization, HMO, Medicare Advantage plan, or payer ...
Quick apply
Experience conducting compliance risk assessments, auditing, monitoring, investigations, and ... Experience within a health plan, managed care organization, HMO, Medicare Advantage plan, or payer ...
Experience conducting compliance risk assessments, auditing, monitoring, investigations, and ... Experience within a health plan, managed care organization, HMO, Medicare Advantage plan, or payer ...
Experience conducting compliance risk assessments, auditing, monitoring, investigations, and ... Experience within a health plan, managed care organization, HMO, Medicare Advantage plan, or payer ...
Lead and implement an effective Compliance Program as described in CMS Medicare Managed Care Manuals/regulations, applicable Medicaid rules and government contracts, including risk assessment ...
Lead and implement an effective Compliance Program as described in CMS Medicare Managed Care Manuals/regulations, applicable Medicaid rules and government contracts, including risk assessment ...
... Medicare, Medicaid, HIPAA Privacy & Security, Fraud, Waste & Abuse, Code of Conduct, ethics, regulatory interpretation, risk assessment, and regulatory change management preferred. * Experience ...
... Medicare, Medicaid, HIPAA Privacy & Security, Fraud, Waste & Abuse, Code of Conduct, ethics, regulatory interpretation, risk assessment, and regulatory change management preferred. * Experience ...
... Medicare, Medicaid, HIPAA Privacy & Security, Fraud, Waste & Abuse, Code of Conduct, ethics, regulatory interpretation, risk assessment, and regulatory change management preferred. * Experience ...
... Medicare, Medicaid, HIPAA Privacy & Security, Fraud, Waste & Abuse, Code of Conduct, ethics, regulatory interpretation, risk assessment, and regulatory change management preferred. * Experience ...
... Medicare, Medicaid, HIPAA Privacy & Security, Fraud, Waste & Abuse, Code of Conduct, ethics, regulatory interpretation, risk assessment, and regulatory change management preferred. * Experience ...
... Medicare, Medicaid, HIPAA Privacy & Security, Fraud, Waste & Abuse, Code of Conduct, ethics, regulatory interpretation, risk assessment, and regulatory change management preferred. * Experience ...
... Medicare, Medicaid, HIPAA Privacy & Security, Fraud, Waste & Abuse, Code of Conduct, ethics, regulatory interpretation, risk assessment, and regulatory change management preferred. * Experience ...
... Medicare, Medicaid, HIPAA Privacy & Security, Fraud, Waste & Abuse, Code of Conduct, ethics, regulatory interpretation, risk assessment, and regulatory change management preferred. * Experience ...
... Medicare Secondary Payor (MSP) Compliance offerings to help us exceed our ambitious sales and ... assess and price risk with speed and precision Claims Solutions - supports end-to-end claims ...
... Medicare Secondary Payor (MSP) Compliance offerings to help us exceed our ambitious sales and ... assess and price risk with speed and precision Claims Solutions - supports end-to-end claims ...
MDS Coordinator
Orange Park, FL · On-site
$28.25 - $36.25/hr
MDS Coordinator administers patient assessments and overseas the assessment process, setting the ... Start Medicare coverage for newly qualified patients and remain updated on changes in Medicare ...
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MDS Coordinator
Orange Park, FL · On-site
$28.25 - $36.25/hr
MDS Coordinator administers patient assessments and overseas the assessment process, setting the ... Start Medicare coverage for newly qualified patients and remain updated on changes in Medicare ...
MDS Coordinator
Mayo, FL · On-site
$29.75 - $38/hr
MDS Coordinator administers patient assessments and overseas the assessment process, setting the ... Start Medicare coverage for newly qualified patients and remain updated on changes in Medicare ...
Quick apply
MDS Coordinator
Mayo, FL · On-site
$29.75 - $38/hr
MDS Coordinator administers patient assessments and overseas the assessment process, setting the ... Start Medicare coverage for newly qualified patients and remain updated on changes in Medicare ...
S. seniors are polychronic, significantly increasing their risk of serious foot issues like ... Schedule in-home health assessments for seniors with Belle's trained technicians. * Overcome ...
S. seniors are polychronic, significantly increasing their risk of serious foot issues like ... Schedule in-home health assessments for seniors with Belle's trained technicians. * Overcome ...
Clinical Reimbursement Specialist RN/LPN
Saint Cloud, FL · On-site
$90K - $100K/yr
... assessments are accurate, timely, clinically supported, and compliant with Medicare, Medicaid ... Conduct scheduled and focused audits based on facility risk, survey findings, denials, quality ...
Clinical Reimbursement Specialist RN/LPN
Saint Cloud, FL · On-site
$90K - $100K/yr
... assessments are accurate, timely, clinically supported, and compliant with Medicare, Medicaid ... Conduct scheduled and focused audits based on facility risk, survey findings, denials, quality ...
S. seniors are polychronic, significantly increasing their risk of serious foot issues like ... Schedule in-home health assessments for seniors with Belle's trained technicians. * Overcome ...
S. seniors are polychronic, significantly increasing their risk of serious foot issues like ... Schedule in-home health assessments for seniors with Belle's trained technicians. * Overcome ...
S. seniors are polychronic, significantly increasing their risk of serious foot issues like ... Schedule in-home health assessments for seniors with Belle's trained technicians. * Overcome ...
S. seniors are polychronic, significantly increasing their risk of serious foot issues like ... Schedule in-home health assessments for seniors with Belle's trained technicians. * Overcome ...
MDS Coordinator
Daytona Beach, FL · On-site
$70K - $82K/yr
MDS Coordinator/Director LPN or R.N administers patient assessments and oversees the assessment ... Start Medicare coverage for newly qualified patients or send out denial letters and remain updated ...
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MDS Coordinator
Daytona Beach, FL · On-site
$70K - $82K/yr
MDS Coordinator/Director LPN or R.N administers patient assessments and oversees the assessment ... Start Medicare coverage for newly qualified patients or send out denial letters and remain updated ...
$33.87 - $57.68/hr
Conducts in depth health risk assessment and/or comprehensive needs assessment which include, but ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...
$33.87 - $57.68/hr
Conducts in depth health risk assessment and/or comprehensive needs assessment which include, but ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...
$33.87 - $57.68/hr
Conducts in depth health risk assessment and/or comprehensive needs assessment which include, but ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...
$33.87 - $57.68/hr
Conducts in depth health risk assessment and/or comprehensive needs assessment which include, but ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...
$33.87 - $57.68/hr
Conducts in depth health risk assessment and/or comprehensive needs assessment which include, but ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...
$33.87 - $57.68/hr
Conducts in depth health risk assessment and/or comprehensive needs assessment which include, but ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...
$33.87 - $57.68/hr
Conducts in depth health risk assessment and/or comprehensive needs assessment which include, but ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...
$33.87 - $57.68/hr
Conducts in depth health risk assessment and/or comprehensive needs assessment which include, but ... Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid ...
Medicare Risk Assessment information
See Florida salary details
$17.26 is the 25th percentile. Wages below this are outliers.
$14.91 - $18.14
34% of jobs
The median wage is $20.16 / hr.
$18.14 - $21.38
25% of jobs
$21.38 - $24.61
0% of jobs
$24.61 - $27.84
0% of jobs
$27.84 - $31.08
6% of jobs
$31.08 - $34.31
2% of jobs
$34.31 - $37.54
5% of jobs
$38.62 is the 75th percentile. Wages above this are outliers.
$37.54 - $40.78
6% of jobs
$40.78 - $44.01
8% of jobs
$44.01 - $47.24
10% of jobs
$47.24 - $50.48
2% of jobs
$14
$28
$50
How much do medicare risk assessment jobs pay per hour?
As of Sep 2, 2026, the average hourly pay for medicare risk assessment in Florida is $28.91, according to ZipRecruiter salary data. Most workers in this role earn between $17.79 and $40.58 per hour, depending on experience, location, and employer.
What is a Medicare Risk Assessment?
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 Florida?
For Medicare Risk Assessment jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Medicare Risk Assessment jobs in Florida look for?
The top searched job categories for Medicare Risk Assessment jobs in Florida are:
What cities in Florida are hiring for Medicare Risk Assessment jobs?
Cities in Florida with the most Medicare Risk Assessment job openings:
Job description
ABOUT THE ROLE
We are seeking an experienced Compliance & Privacy Officer to serve as Capital Health Plan's designated Compliance Officer and Privacy Officer. This executive leadership role is responsible for providing strategic oversight of the organization's Corporate Compliance and Privacy Programs while ensuring compliance with applicable federal and state regulations, contractual obligations, accreditation standards, and organizational policies.
The Compliance & Privacy Officer partners closely with executive leadership and the Board of Directors to identify, assess, and mitigate compliance and privacy risks. This position oversees enterprise compliance initiatives, regulatory monitoring, investigations, auditing activities, privacy programs, and risk management efforts while promoting a culture of integrity, accountability, and ethical conduct throughout the organization.
WE'RE LOOKING FOR SOMEONE WHO HAS- Master's degree (MBA, MHA, MPH, or related field) or equivalent combination of education and experience.
- Four to ten years of progressively responsible experience in healthcare compliance, health plan regulatory compliance, privacy, auditing, risk management, or related disciplines.
- Strong knowledge of healthcare compliance principles, managed care regulations, and health plan operations.
- Experience conducting compliance risk assessments, auditing, monitoring, investigations, and corrective action initiatives.
- Ability to interpret complex regulatory requirements and translate them into practical guidance for leaders and operational teams.
- Excellent executive communication, presentation, and relationship management skills.
- Ability to manage highly confidential and sensitive information while exercising sound judgment and independence.
- Juris Doctor (JD), Master of Healthcare Administration (MHA), Master of Business Administration (MBA), Master of Public Health (MPH), or other related advanced degree.
- Ten or more years of healthcare compliance experience.
- Experience within a health plan, managed care organization, HMO, Medicare Advantage plan, or payer environment.
- Experience interacting with Boards of Directors, Audit Committees, CMS regulators, and external auditors.
- Certification as a Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC), Certified Information Privacy Professional (CIPP), or similar professional credential.
- Experience leading enterprise compliance, privacy, auditing, risk assessment, and corrective action programs.
- Maintains an effective enterprise compliance and privacy program that meets regulatory, contractual, and accreditation requirements.
- Proactively identifies, assesses, and mitigates compliance and privacy risks.
- Provides trusted guidance to executive leadership and the Board regarding regulatory obligations and emerging risks.
- Oversees timely investigations, auditing activities, corrective actions, and privacy response processes.
- Strengthens organizational awareness of ethics, compliance, privacy, and accountability.
- Builds productive relationships with regulators, auditors, providers, executives, and business leaders.
Capital Health Plan is a locally based, notforprofit health maintenance organization that has served the Tallahassee region for more than four decades. Founded by community leaders with a mission to deliver highquality, affordable, and patientcentered health care, CHP is nationally recognized for its strong clinical outcomes, operational excellence, and commitment to the communities it serves.
CHP is proud to be an Equal Opportunity Employer and is committed to maintaining a workplace that values professionalism, integrity, and respect. We provide equal employment opportunities to all employees and applicants and do not discriminate on the basis of any legally protected status.
Must have the ability to pass a background check and drug screening test.
About Capital Health Plan
Sourced by ZipRecruiter
In 1982, a group of Tallahassee’s civic leaders came together to create a quality, affordable health care system to meet the health needs of the community. Forty years later, Capital Health Plan has become a national health care leader. We started with 5,000 members and a network of 75 doctors. We’ve now grown to more than 135,000 members with a broad network of more doctors, hospitals and other health care providers throughout our service area. A key component of CHP’s delivery system is its employed medical staff, who practice in three state-of-the-art health centers CHP has developed to serve its membership. These health centers are equipped with electronic medical records and can accommodate a broad range of preventive, primary, and specialty care services including evening and weekend urgent care, lab, x-ray, digital mammography, ultrasound, colon screening, eye care services, wound care, and a center focused on the needs of chronically ill members. CHP’s ability to offer this highly organized component of its delivery system provides unique opportunities for adding value. The staff model of CHP’s delivery system is the engine of our program, consistently driving better results on measures of clinical care, member satisfaction, and affordability. As a not-for-profit HMO, we exist to improve the health of our communities by providing high quality, comprehensive health plans with low administrative costs, through primary care focused, patient-centered healthcare.
Industry
Health care and social assistance
Company size
201 - 500 Employees
Headquarters location
Tallahassee, FL, US
Year founded
1982