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Nurse Risk Adjustment Jobs in Ohio (NOW HIRING)

Purposelink Recruitment

Remote Nurse Practitioner

OH · Remote

Family Nurse Practitioner (FNP) - Ohio * OR any of the following nationally recognized NP ... Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures * Background ...

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Nurse Risk Adjustment information

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 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.

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 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 popular job titles related to Nurse Risk Adjustment jobs in Ohio?

For Nurse Risk Adjustment jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Nurse Risk Adjustment jobs in Ohio look for?

The top searched job categories for Nurse Risk Adjustment jobs in Ohio are:

What cities in Ohio are hiring for Nurse Risk Adjustment jobs?

Cities in Ohio with the most Nurse Risk Adjustment job openings:

Nurse Risk Adjustment jobs near you
Infographic showing various Nurse Risk Adjustment job openings in Ohio as of August 2026, with employment types broken down into 76% Full Time, 12% Part Time, 4% Temporary, and 8% Contract. Highlights an 88% In-person, and 12% Remote job distribution.

Field Nurse Practitioner / Physician Assistant - Montgomery County, Ohio

Advantmed

Dayton, OH • On-site

$137.76/hr

Other

Re-posted 19 days ago

Job description

About Advantmed

Advantmed is a leading provider of risk adjustment, quality improvement and value-based solutions to health plans and providers. We drive market leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance, and the proactive clinical engagement of high acuity populations.

The building B.L.O.C.K.S. of our team’s success!

Bring the fun

Leverage together for better

Outperform yourself

Care at every touchpoint

Keep your word. Keep it real

Stay curious & listen well

Primary Purpose

We are proud of the quality care we provide members and our team is rapidly expanding to meet the demands of our growing business; we are seeking a highly skilled and compassionate certified Nurse Practitioner to join our Advantmed provider network. In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare members and other at risk populations. Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care. This role is 1099 (PRN) and offers tremendous flexibility and opportunity for those who are balancing competing priorities.

Learn more about our primary purpose here

Follow us on LinkedIn:

https://www.linkedin.com/company/advantmed

NP Responsibilities
  • Perform annual in-home wellness visits and risk adjustment health assessments on a population with chronic conditions; Our thorough evaluations include: a comprehensive assessment, physical examination, body system review, vital signs, review of medication history, review of current prescriptions, review of member functional status, pain management, cognitive assessment, review of the home environment, fall risk screening, social assessment, review of daily living activities, mental health screening, documentation and communication
  • You will play a pivotal role in providing individualized quality care to the elderly population in their homes
  • Deliver patient health education on topics such as pain management, medication, etc.
  • Build relationships of trust with members through exceptional communication and empathy
  • Assist in closing quality care gaps (i.e. screenings and labs)
  • An enthusiastic collaborator contributing to the enhancement of care delivery
  • Providers are expected to commit a minimum of 30 hours per month
Locations
  • Montgomery County, Ohio
NP Qualifications
  • Must have a valid unencumbered NP License for the state you will be working in
  • This role requires travel within the assigned job posting county up to a maximum 55-mile radius
  • Previous in-home risk assessment experience preferred
  • Previous 1099 (PRN) experience is preferred but not required
  • 3 years patient care experience preferred (primary care/adult/geriatric, EMR)
  • May be requested to obtain additional NP licensure supported by Advantmed
  • Access to reliable transportation that will enable you to travel to member's homes within a designated area
  • Strong ability to work within our EMR system
  • Ability to work independently
  • Bilingual is a plus
Advantmed offers
  • Competitive compensation of ~$100 per completed in-home health assessment
  • Paid mileage
  • Flexible work schedule
  • Never on-call
  • Visits ready to be scheduled immediately
  • Appointment confirmation support
  • Dedicated coordinator support
  • Advanced member scheduling coverage
  • State of art technology
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