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Nurse Risk Adjustment Jobs in Alabama (NOW HIRING)

VIVA Health

RN-Clinical Quality Liaison

Birmingham, AL · On-site

$61K - $82K/yr

Birmingham, AL The RN, Clinical Quality Liaison plays a critical role in improving quality outcomes and risk adjustment performance within the University of Alabama (UAB) health system and large ...

Urrly

Telehealth Nurse Practitioner

Huntsville, AL · Remote

$600 - $720/day

Telehealth Nurse Practitioner * Location/Type: Alabama Remote (No travel) * Pay: $600-$720/day ... Document risk adjustment (HCC coding) during patient visits * Close HEDIS care gaps during visits

Baptistfirst

The Supervisor shall participate in staffing by making the necessary adjustments to provide the ... Occasional exposure to risk of electrical shock. Some exposure to infectious disease while ...

CVS Health

Senior Medical Director

Mobile, AL

... Risk Adjustment Clinical Compliance & Policy Development This includes representing Oak Street to ... Supervising the Transitions Nurses, who track all hospitalized patients and coordinate post ...

Legacy Senior Living

PT- (LPN) 1ST Shift

Opelika, AL · On-site

$22.25 - $30.25/hr

... and schedule adjustments at change-of-shift huddles • Foster a supportive, collaborative ... Risk Exposure Factor It is highly likely that while performing functions assigned to this position ...

Legacy Senior Living

PT- (LPN) 1ST Shift

Opelika, AL · On-site

$23.75 - $32.25/hr

... and schedule adjustments at change-of-shift huddles • Foster a supportive, collaborative ... Risk Exposure Factor It is highly likely that while performing functions assigned to this position ...

Corvel

Medical Case Manager I

Birmingham, AL · On-site

$63K - $95K/yr

Utilizes their medical and nursing knowledge to discuss the current treatment plan with the ... The level may impact the salary range and these adjustments would be clarified during the offer ...

Corvel

Medical Case Manager I

Birmingham, AL · On-site

$63K - $95K/yr

Utilizes their medical and nursing knowledge to discuss the current treatment plan with the ... The level may impact the salary range and these adjustments would be clarified during the offer ...

Corvel

Medical Case Manager I

Troy, AL · On-site

$63K - $95K/yr

Utilizes their medical and nursing knowledge to discuss the current treatment plan with the ... The level may impact the salary range and these adjustments would be clarified during the offer ...

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Nurse Risk Adjustment information

How does a nurse risk adjustment professional typically collaborate with coding and provider teams to ensure accurate risk scoring?

Nurse Risk Adjustment professionals often work closely with medical coders and healthcare providers to review patient documentation and ensure diagnoses are captured accurately for risk adjustment purposes. They may participate in interdisciplinary meetings, provide education to providers on documentation best practices, and clarify coding queries. This collaborative approach helps optimize the accuracy of risk scores, which impacts reimbursement and quality metrics. Effective communication and teamwork are essential in this role to support compliance and achieve organizational goals.

What is a nurse risk adjustment?

Nurse risk adjustment nurses are specialized healthcare professionals who review patient medical records to ensure accurate documentation of diagnoses and health conditions. Their work supports the risk adjustment process, which helps health plans and providers receive appropriate compensation based on the health status of their patient populations. These nurses use their clinical expertise to identify missing or undocumented conditions, collaborate with providers to improve documentation accuracy, and help ensure compliance with federal guidelines. By doing so, they play a key role in improving patient care quality and the financial health of healthcare organizations.

What is the difference between Nurse Risk Adjustment vs Nurse Case Manager?

AspectNurse Risk AdjustmentNurse Case Manager
CertificationsRN license, risk adjustment trainingRN license, case management certification
Work EnvironmentInsurance companies, healthcare analyticsHospitals, clinics, patient homes
Employer & IndustryHealth plans, insurance providersHealthcare providers, hospitals

While both roles require RN licensure, Nurse Risk Adjustment focuses on analyzing and coding patient data for insurance risk models, whereas Nurse Case Managers coordinate patient care and manage treatment plans. Understanding these differences helps professionals choose the right career path within healthcare and insurance industries.

What are the key skills and qualifications needed to thrive as a nurse risk adjustment?

To thrive as a Nurse Risk Adjustment, you need a solid background in clinical nursing, comprehensive knowledge of medical coding (especially ICD-10), and familiarity with risk adjustment methodologies, typically supported by RN licensure and experience in case management or chart review. Proficiency with electronic health record (EHR) systems, coding software, and sometimes a Certified Risk Adjustment Coder (CRC) credential is valuable. Attention to detail, analytical thinking, and strong communication skills help nurses accurately review documentation and collaborate with providers. These skills ensure accurate coding and risk stratification, which directly impact healthcare reimbursement and quality reporting.
What are popular job titles related to Nurse Risk Adjustment jobs in Alabama? For Nurse Risk Adjustment jobs in Alabama, the most frequently searched job titles are:
What job categories do people searching Nurse Risk Adjustment jobs in Alabama look for? The top searched job categories for Nurse Risk Adjustment jobs in Alabama are:
What cities in Alabama are hiring for Nurse Risk Adjustment jobs? Cities in Alabama with the most Nurse Risk Adjustment job openings:
Nurse Risk Adjustment jobs near you
Infographic showing various Nurse Risk Adjustment job openings in Alabama as of August 2026, with employment types broken down into 86% Full Time, and 14% Part Time. Highlights an 86% In-person, and 14% Remote job distribution.

RN-Clinical Quality Liaison

VIVA Health

Birmingham, AL • On-site

$61K - $82K/yr

Full-time

Re-posted 27 days ago

Viva Health rating

8.1

Company rating: 8.1 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

152nd of 303 rated insurance

Job description

RN, Clinical Quality Liaison

Location: Birmingham, AL

The RN, Clinical Quality Liaison plays a critical role in improving quality outcomes and risk adjustment performance within the University of Alabama (UAB) health system and large clinical practice. This practicededicated role serves as the primary clinical liaison for Primary Care Physicians (PCPs) and  practice staff, driving performance improvement related to Star Ratings, HEDIS measures, risk adjustment and coding completeness. This position requires advanced clinical knowledge, analytical skills and the ability to influence change at the practice level through deep engagement, workflow redesign, clinical education and datadriven targeting. This role translates organizational goals into sustainable, scalable solutions within the assigned practice that supports both quality outcomes and financial performance drivers. This position may travel to locations within the Viva HEALTH service area through a reliable means of transportation insured in accordance with Company policy.

REQUIRED:

  • Graduate of an accredited program of professional nursing, ADN/BSN
  • Minimum of 5 years’ experience in quality improvement, population health or practice performance support
  • Current RN License in good standing with the state of Alabama Board of Nursing
  • Willing to submit to vaccine testing and screening
  • Strong clinical assessment and judgment
  • Working knowledge of Stars, HEDIS and risk adjustment methodologies
  • Ability to interpret data and translate metrics into targeted clinical action
  • Ability to engage, educate and influence physicians and practice staff
  • Experience with workflow redesign and performance improvement initiatives
  • Organized, detail oriented and skilled at multi-tasking
  • Strong written and verbal communication skills
  • Proficient in Microsoft Office suite of products and EHR systems
  • Ability to work under pressure and manage multiple priorities with limited supervision
  • Valid driver's license in good standing

PREFERRED:

  • Experience supporting risk adjustment, coding, or data-driven performance initiatives
  • Experience supporting coding completeness or chronic condition documentation
  • Familiarity with attribution management and population-level analytics

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