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Medicare Risk Assessment Jobs in Tennessee (NOW HIRING)

Urrly

Telehealth Nurse Practitioner

Nashville, TN · Remote

$600 - $720/day

... Medicare and Medicaid populations through virtual care. What You'll Do * Conduct Comprehensive Health Assessments via telehealth * Document risk adjustment (HCC coding) during patient visits * Close ...

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Medicare Risk Assessment information

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 Tennessee? For Medicare Risk Assessment jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Medicare Risk Assessment jobs in Tennessee look for? The top searched job categories for Medicare Risk Assessment jobs in Tennessee are:
Medicare Risk Assessment jobs near you
Infographic showing various Medicare Risk Assessment job openings in Tennessee as of July 2026, with employment types broken down into 2% As Needed, 78% Full Time, 17% Part Time, and 3% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution.

Clinical Compliance Manager

Monogram Health

Brentwood, TN • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 10 days ago

Job description

Position: Clinical Compliance Manager
Monogram Health is looking for a Clinical Compliance Manager to support and enhance our Compliance Program through oversight, risk assessment, and cross-functional collaboration. This role provides critical compliance guidance and leads certain monitoring and audit activities.
Reporting to the Senior Director of Compliance, this position is key to driving a strong culture of compliance and ethical practice across the organization. Hybrid position preferred in either the Tempe AZ or Brentwood TN office location.
Responsibilities
  • Lead, administer, and continuously improve key components of the Compliance Program to support organizational objectives.
  • Conduct compliance oversight activities, including monitoring and auditing, to assess adherence to regulatory requirements (e.g., CMS) and contractual obligations.
  • Drive and support compliance risk assessments, as well as work plan development and implementation, aligning enterprise priorities with regulatory expectations.
  • Serve as a primary liaison internally for assigned compliance activities, including audits, inquiries, etc. as tied to the annual risk assessment and compliance workplan.
  • Provide subject matter expertise and strategic guidance to cross-functional teams on compliance matters, including interpretation and implementation of regulatory and contractual requirements.
  • Collaborate with operational leaders to develop, review, and update policies and procedures in connection with completed compliance audit and monitoring activities.
  • Develop and deliver reports and presentations on compliance activities, including audit and monitoring results to leadership and stakeholders.
  • Lead or contribute to compliance-related projects, initiatives, and research to support program effectiveness and regulatory readiness.
  • Conduct internal investigations related to concerns reported via the Compliance & Ethics Helpline or directly to the Compliance team; ensure proper documentation, tracking, and reporting.

Position Requirements
  • Bachelor's degree in healthcare, nursing, legal studies, or a related field, or equivalent combination of education and relevant experience.
  • Minimum of five (5) years of experience in Medicare Managed Care, with preferred expertise in Special Needs Plan Model of Care (SNP MOC) requirements, including D-SNP and C-SNP with at least three (3) years of leadership or supervisory experience, with demonstrated ability to influence and guide cross-functional teams.
  • Active, unrestricted Registered Nurse (RN) license required.
  • Certified in Healthcare Compliance (CHC) preferred (or willingness to obtain certification within a defined timeframe).
  • Extensive knowledge of Medicare and Medicaid compliance programs, including applicable regulatory frameworks and audit expectations.
  • Influencing and stakeholder management skills, with the ability to build trust and drive alignment across cross-functional teams.
  • Written and verbal communication skills, including the ability to translate complex regulatory requirements into clear, actionable guidance for diverse audiences.
  • Critical thinking and risk-based decision-making skills, with the ability to assess compliance risks and recommend practical, business-aligned solutions.
  • Integrity and ethical judgment, with a commitment to fostering a culture of accountability, transparency, and compliance.

Benefits
  • Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
  • Financial & Retirement Support - Competitive compensation, 401k with employer match, and financial wellness resources
  • Time Off & Leave - Paid holidays, flexible vacation time/PSSL, and paid parental leave
  • Wellness & Growth - Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts

About Monogram Health
Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person's health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient's healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health's personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.
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Equal Opportunity Employer
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