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Nurse Risk Adjustment Jobs in Michigan (NOW HIRING)

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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.
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Nurse Risk Adjustment jobs near you

Field Nurse Practitioner / Physician Assistant - Roscommon County, Michigan

Advantmed

Roscommon, MI

$100/hr

Contractor

Posted 29 days ago

Job description

Field Nurse Practitioner / Physician Assistant

  • Pay - ~$100 per completed assessment + paid mileage
  • Schedule - Flexible weekdays | No evenings, weekends, or oncall
  • Work Model - 1099 Independent Contractor (PRN)

Designed for NPs and PAs seeking reliable, ongoing PRN income with structure and support.

About the Role

  • Advantmed is seeking a licensed, dependable Nurse Practitioner (NP) or Physician Assistant (PA) to conduct structured, in-home wellness and risk adjustment assessments for diverse patient populations with varying healthcare needs
  • This PRN role offers flexibility with consistent visit availability and strong operational support. It is best suited for clinicians who value autonomy, professionalism, and accountability, and are looking for steady supplemental income - not short-term or ad hoc work.

Why Advantmed

  • Partnering with 40+ health plans and supporting 1M+ providers nationwide
  • 99% Provider Satisfaction and 97% Member Satisfaction
  • 30%+ In Home Assessment completion rates, even in complex populations
  • Clinically led, quality-first organization with standardized visits and strong QA
  • Technology-enabled workflows and structured training from day one

Why You'll Like This Role

  • Paid training and standardized onboarding
  • ~$100 per completed visit + mileage reimbursement
  • Most providers complete 4-5 visits per day, based on availability
  • Visits ready to schedule immediately
  • Choose your own weekday availability
  • Dedicated coordinators, scheduling, and tech support
  • Predictable workflows with clinical and operational support

What You'll Do

  • Conduct in-home Annual Wellness Visits and chronic condition assessments
  • Perform focused histories, physical exams, vitals, medication reviews, and screenings
  • Complete screenings including:
    • Hemoglobin A1C
    • Spirometry
    • KED (Kidney Health Evaluation)
    • DRE (Diabetic Retinal Exam)
    • FIT (Fecal Immunochemical Test)
  • Educate members on preventive care and chronic disease management
  • Document visits in the EMR to support value-based care and risk adjustment
  • Operate within NP or PA scope of practice and state regulatory guidelines

All assessments are standardized, with full training, equipment guidance, and EMR support provided.

Important Role Expectations

This is a 1099 PRN role requiring consistency and reliability:

  • Maintain ongoing monthly availability
  • Be responsive during onboarding and scheduling
  • Honor confirmed visits and assignments
  • Work independently and professionally in the field
  • Minimum commitment: ~30 hours per month, ongoing (Not intended for casual or short-term engagement)
  • Travel daily within a ~55-mile radius of the assigned county
  • Adhere to state-specific supervision or collaboration requirements (for PAs where applicable)

Qualifications

  • Active, unencumbered NP or PA license in the applicable state
  • Ability to practice within applicable state guidelines, including supervision / collaboration requirements (for PAs)
  • 3+ years of patient care experience preferred
  • Comfortable with EMR systems and independent field-based work
  • In-home or risk adjustment experience preferred
  • Willing to obtain additional licensure if needed (supported by Advantmed)

What Advantmed Offers

  • Competitive per-visit compensation
  • Paid mileage
  • Flexible, provider-driven scheduling
  • Pre-scheduled appointments with confirmation support
  • Dedicated coordinator and clinical escalation support
  • Modern, technology-enabled documentation workflows


Apply