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Nurse Risk Adjustment Jobs in Indiana (NOW HIRING)

Strive Health

Nurse Practitioner

Schererville, IN

$112K - $140K/yr

Strive is fiercely committed to advancing technology that makes the Nurse Practitioner role as ... Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and ...

Traditions Management

Licensed Practical Nurse

Columbus, IN · On-site

$24 - $32.50/hr

... make adjustments according to qualified staff availability and resident needs. • Provides ... Modifies approaches in service plan to accommodate resident needs and preferences to manage risk ...

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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 are nurse risk adjustment nurses?

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, and why are they important?

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 Indiana? For Nurse Risk Adjustment jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Nurse Risk Adjustment jobs in Indiana look for? The top searched job categories for Nurse Risk Adjustment jobs in Indiana are:
What cities in Indiana are hiring for Nurse Risk Adjustment jobs? Cities in Indiana with the most Nurse Risk Adjustment job openings:
Nurse Risk Adjustment jobs near you
Nurse Practitioner

Nurse Practitioner

Strive Health

Schererville, IN

$112K - $140K/yr

Other

Posted 12 days ago

Key responsibilities

  • Manages a defined patient panel with accountability for quality, cost, and outcomes, collaborating with external providers and care teams to ensure goals, treatment, and care plan alignment.

  • Obtains patient history, performs physical exams, orders and interprets diagnostic tests, and formulates plans for individual patient short-term and longitudinal needs.

  • Ensures assessment and plan of care incorporate best practices for chronic kidney care, supports transitions to renal replacement therapy, transplant, or conservative care, and participates in shared decision-making and end-of-life or advanced care planning discussions.

Job description

How You'll Make An Impact

As a Clinical Lead within our interdisciplinary team, you do more than treat a diagnosis-you are the visionary architect of a better life for patients navigating the complexities of CHF, CKD/ESKD, and other chronic conditions. At Strive, we have shattered the constraints of the 15-minute office visit. Here, you are granted the true autonomy to provide longitudinal, deeply personal care that meets patients exactly where they are: in their homes and via telehealth.

In this role, you will harness the power of advanced analytics, cutting-edge technology platforms, and seamless interdisciplinary collaboration to ensure world-class care reaches the right patient at the precise moment they need it. As the trusted navigator for a dedicated panel, you will blend high-touch clinical expertise with a radical "whole-person" approach. Your mission is to move the needle on what truly matters:

  • Keeping patients out of the hospital.
  • Slowing disease progression, ensuring every individual feels seen, heard, and deeply cared for.

Strive is fiercely committed to advancing technology that makes the Nurse Practitioner role as efficient as it is impactful. We are obsessed with reducing administrative burden, clearing the path so you can reclaim your time for what you do best: meaningful clinical care and transformative patient engagement.

The Day to Day  

  • Manages a defined patient panel with accountability for quality, cost and outcomes. Collaborates with external providers and care teams to ensure goals, treatment, and care plan alignment.
  • Obtains patient history,performs physical exam, orders and interprets diagnostic tests and formulates a plan for individual patient short-term and longitudinal needs.
  • Ensures assessment and plan of care incorporate best practices for chronic kidney care including management of all stages of CKD, ESKD and heart failure.  Will support transitions to renal replacement therapy, transplant, or conservative care) as well as participation in shared decision-making and end-of-life/advanced care planning discussions.
  • Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care.
  • Presents patient cases and provides clinical support for clinical rounds and interdisciplinary team meetings.
  • Serves patients and performs patient visits in multiple care settings a including patient home, telehealth visits or dialysis clinics/partner MD space (where applicable).
  • Responsible for maintaining current board certification and state-specific continuing education requirements.
  • Adheres to expectations outlined in Strive's documentation policy
  • Provides in-person patient care which may include standing, sitting, walking, pushing, pulling, and lifting. 

Minimum Qualifications 

  • Master's degree in Nursingor similar field.
  • 2+ years experience as a Family Nurse Practitioner (NP), Primary Care Nurse Practitioner (NP) or equivalent with specialization in cardiology (CHF) or Nephrology (CKD)
  • 2+ years experience with Electronic Health Records (EHR)
  • Current state specific licensure.
  • National Board Certification.
  • Current Drug Enforcement Administration (DEA) license or eligible to obtain within 90 days of hire.
  • Current BLS or CPR Certification.
  • Efficient and reliable transportation, including an active driver's license, allowing for the ability to travel across an assigned region to meet patient needs. Locations may include offices, clinics, and patient homes.
  • Basic computer and Microsoft Office skills
  • Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms. 

Preferred Qualifications 

  • Demonstrated expertise in CKD management (Stages 3-5), ESRD care, and dialysis management (hemodialysis and/or peritoneal dialysis, HHD), including medication optimization, volume assessment, and complication management
  • Experience leading care transitions across settings (hospital outpatient dialysis) with a focus on reducing readmissions and ensuring continuity of care
  • Proven ability to deliver comprehensive patient education on kidney disease progression, dialysis modality selection (home vs. in-center), and kidney transplant pathways to support informed, shared decision-making
  • 2+ years experience with Electronic Health Records (EHR).
  • WoundCarecertification
  • Experience using audio-visual technology platforms 

About You 

  • Demonstrated proficiency in clinical assessment, diagnosis, planning, implementation, documentation, and evaluationof complex chronic patients.
  • Excellent communicator, team builder, and evidence of results.
  • Demonstrated knowledge and understanding of data and managing clinical, financial, and patient satisfaction outcomes.
  • Excels at developing and fostering strong patient and family relationships that center on engagement, trust, honesty, empathy, follow-through and doing what's best for the patient.

Annual Salary Range: $112,000.00-$140,000.00. **This role is eligible for a geographic differential of 8% if located within 50 miles of the Chicago Metro area. This position is also eligible for a target annual bonus of 10%

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