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Nurse Risk Adjustment Jobs in Texas (NOW HIRING)

Palm Medical Centers

Primary Care Physician

Dallas, TX · On-site

$250K - $300K/yr

Collaborate closely with care teams including nurse practitioners, medical assistants, case ... Strong understanding of HEDIS, STAR ratings, risk adjustment, and preventative care measures

Palm Medical Centers

Primary Care Physician

Azle, TX · On-site

Collaborate closely with care teams including nurse practitioners, medical assistants, case ... Strong understanding of HEDIS, STAR ratings, risk adjustment, and preventative care measures

Palm Medical Centers

Primary Care Physician

Azle, TX · On-site

Collaborate closely with care teams including nurse practitioners, medical assistants, case ... Strong understanding of HEDIS, STAR ratings, risk adjustment, and preventative care measures

Palm Medical Centers

Primary Care Physician

Azle, TX · On-site

Collaborate closely with care teams including nurse practitioners, medical assistants, case ... Strong understanding of HEDIS, STAR ratings, risk adjustment, and preventative care measures

Palm Medical Centers

Primary Care Physician

Azle, TX · On-site

Collaborate closely with care teams including nurse practitioners, medical assistants, case ... Strong understanding of HEDIS, STAR ratings, risk adjustment, and preventative care measures

Strive Health

Nurse Practitioner

Houston, TX · On-site

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and ... Master's degree in Nursing or similar field. * 2+ years experience as a Family Nurse Practitioner ...

Apex Health Solutions

Patient Care Advocate

Houston, TX

$17 - $22/hr

Licensed Vocational Nurse (LVN) * Registered Nurse (RN) * Social Worker (LSW) EXPERIENCE: * Work ... improvement & risk adjustment initiatives * Arranges transportation for members as needed.

Strive Health

Nurse Practitioner

Houston, TX · On-site

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and ... Master's degree in Nursing or similar field. * 2+ years experience as a Family Nurse Practitioner ...

Apex Health Solutions

Patient Care Advocate

Houston, TX · On-site

$17 - $22/hr

... Nurse (LVN) • Registered Nurse (RN) • Social Worker (LSW) EXPERIENCE: • Work experience ... risk adjustment initiatives • Arranges transportation for members as needed. • Arranges ...

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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 Texas?

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

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

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

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

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

Nurse Risk Adjustment jobs near you
Infographic showing various Nurse Risk Adjustment job openings in Texas as of August 2026, with employment types broken down into 100% Full Time. Highlights an 84% In-person, and 16% Remote job distribution.

Nurse Practitioner - Flagship Health (Live Oak/San Antonio, TX)

Alpine Physician Partners

San Antonio, TX • On-site

Other

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Job Description:
Flagship Health Job Description:
  • Nurse Practitioner or Physician Assistant: Will be responsible for serving as primary care provider for assigned Flagship Health patients.
  • Clinical Operations Development: Lead a Clinical and Support Team in the development, implementation, and execution of effective clinical programs, business operations, community support, social services, and wellness services.
  • Support Organizational Strategy: Support our goal of continuous improvement. Work collaboratively as a leader at the deck plate, sharing best practices and improvement opportunities.
  • The Staff APP duties are primarily focused on the performance of the clinical and associated business operations, but they will have strategic input into a variety of organizational-wide projects and other initiatives which will fall into the following categories:
    • Care Management
    • Quality Improvement
    • Utilization Management
    • Clinical Committee Functions/Leadership
    • Network Management
    • Health Plan Management
    • Documentation/Risk Adjustment
    • Clinical Compliance & Policy Development
  • Drive Culture: Flagship Health fosters a culture of innovation and open dialogue. In addition, the team works with urgency. This requires passion and enthusiasm, active listening skills, and comfort with and commitment to regular change. Our physicians are expected to support this culture and set an example for others to follow:
QUALITIES & ABILITIES:
  • Proven Leadership Skills with the ability to Develop High Functioning Teams
  • Startup Mentality & Growth Mindset
  • Innovative and Creative
  • Value-Based Care Experience and Orientation
  • Commitment to our Veteran population
  • Passionate about their work and motivated to be a part of a fast-growing organization.
  • Aware of their leadership skills and potential for impact and eager to share those with an energetic team on the leading edge of healthcare innovation.
  • Extensive experience in clinical leadership roles, leading and coaching physicians/clinical staff.
  • Experience using a metrics-driven approach to analyze cost, quality, and satisfaction data to drive clinical strategy and program redesign.
  • Excited by process of developing and implementing new processes.
  • Belief that population health and a focus on smart allocation of scarce resources can lead to high value care (better care, lower cost), both in terms of quality and safety.
  • Ability to maintain composure under challenging circumstances while guiding others to effective solutions.
  • Comfort with ambiguity and a passion for problem solving
EXPERIENCE:
  • 5+ years of experience in outpatient practice (preferred)
  • Military or Veterans Health Administration Experience (preferred)
EDUCATION / TRAINING / LICENSURE:
  • Nurse Practitioner or Physician Assistant Certification

Salary Range:

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