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Nurse Risk Adjustment Jobs in Virginia (NOW HIRING)

Upperline Health

Nurse Practitioner

Virginia Beach, VA · On-site

$15K/yr

Complete accurate and timely documentation according to risk adjustment standards per education ... Master's degree in nursing required. * Board Certification as an Adult, Adult-Geriatric or Family ...

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

Field Nurse Practitioner - Richmond, Virginia

Advantmed

Richmond, VA • On-site

$100/hr

Contractor

Posted 17 days ago

Job description

Nurse Practitioner (1099 / PRN) - In Home Assessments
  • Pay - ~$100 per completed assessment + paid mileage
  • Schedule - Flexible weekdays No evenings, weekends, or on-call
  • Work Model - 1099 Independent Contractor (PRN)

Designed for NPs seeking reliable, ongoing PRN income with structure and support
About the Role
  • Advantmed is seeking a licensed, dependable Nurse Practitioner 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 NPs 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 clear training from day one

Why You'll Like This Role
  • Paid training and standardized onboarding
  • ~$100 per completed visit + mileage
  • 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

What You'll Do
  • Conduct in home Annual Wellness Visits and chronic condition assessments
  • Perform focused histories, exams, vitals, medication reviews, and screenings
  • Screenings: Hemoglobin A1C, Spirometry, KED (Kidney Health Evaluation), DRE (Diabetic Retinal Exam), FIT
  • Educate members on preventive care and chronic disease management
  • Document visits in the EMR to support value-based care and risk adjustment

All assessments are standardized, with 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 very short-term engagement.
Travel Expectations: Daily travel within a 55-mile radius of the assigned county
Qualifications
  • Active, unencumbered NP license in the applicable state
  • 3+ years of patient care experience preferred
  • Comfortable with EMR systems and independent 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
  • Appointment confirmation and advanced member scheduling support
  • Dedicated coordinator and clinical escalation support
  • Modern, technology enabled documentation workflows

Apply