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Nurse Risk Manager Jobs in Rutland, MA (NOW HIRING)

Mass Advantage

Manager, Risk Adjustment

Worcester, MA · On-site

We are looking for a Manager of Risk Managment to oversee Mass Advantages's full suite of Risk ... Registered Nurse (RN) desired. * CRC (Certified Risk Adjustment Coder), CPC, or CCS certification ...

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Nurse Risk Manager information

See Rutland, MA salary details

$54.4K

$117.7K

$179.4K

How much do nurse risk manager jobs pay per year?

As of Aug 17, 2026, the average yearly pay for nurse risk manager in Rutland, MA is $117,741.00, according to ZipRecruiter salary data. Most workers in this role earn between $95,000.00 and $136,200.00 per year, depending on experience, location, and employer.

What is a nurse risk manager?

A Nurse Risk Manager is a registered nurse who specializes in identifying, evaluating, and minimizing risks to patients and healthcare organizations. They work to improve patient safety, investigate adverse events, and ensure compliance with healthcare regulations. Nurse Risk Managers collaborate with clinical staff, administrators, and legal teams to develop policies and training that reduce liability and enhance care quality. Their goal is to create a safe environment for both patients and staff while protecting the organization from legal and financial risks.

What is the difference between Nurse Risk Manager vs Nurse Safety Coordinator?

AspectNurse Risk ManagerNurse Safety Coordinator
CertificationsRN license, risk management certificationsRN license, safety certifications
Work EnvironmentHospitals, healthcare facilities, risk departmentsHospitals, clinics, safety departments
Primary FocusRisk mitigation, legal compliance, incident investigationWorkplace safety, safety protocols, staff training

The Nurse Risk Manager and Nurse Safety Coordinator roles both focus on healthcare safety but differ in scope. The Nurse Risk Manager primarily handles risk mitigation and legal compliance, while the Nurse Safety Coordinator emphasizes workplace safety and staff training. Both roles require RN licensure and relevant certifications, often working within similar healthcare environments.

What are the key skills and qualifications needed to thrive as a nurse risk manager, and why are they important?

To thrive as a Nurse Risk Manager, you need a solid clinical background, knowledge of healthcare regulations, and a bachelor's or master's degree in nursing—often with certification in risk management. Familiarity with incident reporting systems, root cause analysis tools, and regulatory compliance software is essential. Strong analytical skills, attention to detail, and effective communication are crucial soft skills for this role. These competencies help identify and mitigate risks, enhance patient safety, and ensure compliance with healthcare standards.

What are some common challenges faced by nurse risk managers when balancing patient care and regulatory compliance?

Nurse Risk Managers often encounter the challenge of ensuring high-quality patient care while meticulously adhering to regulatory standards and hospital policies. They must stay up-to-date with evolving healthcare regulations and respond quickly to incidents or potential risks, which can require rapid decision-making and effective communication with clinical staff. Balancing these responsibilities, especially during high-stress situations or when implementing new protocols, demands strong organizational skills and the ability to educate and support fellow staff members without disrupting patient care.

What are popular job titles related to Nurse Risk Manager jobs in Rutland, MA?

For Nurse Risk Manager jobs in Rutland, MA, the most frequently searched job titles are:

What cities near Rutland, MA are hiring for Nurse Risk Manager jobs?

Cities near Rutland, MA with the most Nurse Risk Manager job openings:

Nurse Risk Manager jobs near you
Infographic showing various Nurse Risk Manager job openings in Rutland, MA as of August 2026, with employment types broken down into 84% Full Time, 13% Part Time, and 3% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $117,741 per year, or $56.6 per hour.

Manager, Risk Adjustment

Mass Advantage

Worcester, MA • On-site

Full-time

Re-posted 2 days ago

Job description

Description

Mass Advantage is a Medicare Advantage health plan, located in the heart of Worcester County, headquartered in Worcester MA. Mass Advantage is owned and designed by UMass Memorial Health providers with their patients' needs in mind.


We are looking for a Manager of Risk Managment to oversee Mass Advantages's full suite of Risk Adjustment activities. This position is responsible for the strategy, execution and performance of Medicare risk adjustment programs, infrastructure and systems to meet business objectives, revenue expectations, management of external vendors, interaction with Providers, regulatory audits, and compliance with CMS regulations. The Manager of Risk Management is also responsible for analysis, projections, and assessment of Medicare revenue initiatives for senior products; leading and coordinating enterprise risk adjustment initiatives, working with the necessary areas of Mass Advantage and UMass Memorial Health Operations as well as vendor partners.


Essential Duties and Responsibilities:

Program Strategy & Execution

  • Own end-to-end RA strategy across prospective (point-of-care capture, suspecting, provider workflows) and retrospective (chart review, coding validation) programs, ensuring complete, accurate, and compliant HCC documentation under the applicable CMS-HCC model (including V24 -V28 transition management).
  • Evaluate current vendor performance, renegotiating or sunsetting SOWs where internal capability is superior.
  • Serve as the plan-side counterpart to UMMH CDI, HIM, and Coding leadership, coordinating with the CMO's office to embed documentation workflows into Epic-based clinical practice rather than layered on top of it.
  • Partner with Network and Clinical Services to design provider-facing education, scorecards, and incentive structures that drive documentation accuracy without creating coding-driven behavior.
  • Develop provider-level performance reporting that is transparent, defensible, and actionable.

RADV, Audit & Compliance

  • Lead RADV audit readiness and response, including medical record retrieval, validation, submission strategy, and cross-functional coordination with Legal, Compliance, and Finance to mitigate financial and compliance risk.
  • Maintain a comprehensive QA program covering RADV, OIG, and internal audits - monitoring the work of internal coders, contracted vendors, and provider documentation alike.
  • Own encounter data integrity, including EDPS submission accuracy, RAPS/EDPS reconciliation, and error resolution.

Analytics, Finance & Bid Support

  • Build and maintain the RA analytics layer - dashboards, KPIs, and provider/member-level reporting that drive continuous improvement in risk score accuracy, coding yield, and program ROI.
  • Partner with Actuarial and Finance on bid development, producing defensible risk score projections, trend analysis, and revenue assumptions grounded in population severity and program performance.
  • Communicate results to executive and board audiences through clear reports, dashboards, and presentations.

Program & Team Leadership

  • Set departmental goals, budgets, and tactical plans aligned with enterprise strategy and financial targets.
  • Other duties may be assigned as needed. 

* Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.


Requirements

  • Bachelor's degree in a relevant field; Master's (MBA, MHA, MPH) preferred.
  • Registered Nurse (RN) desired. 
  • CRC (Certified Risk Adjustment Coder), CPC, or CCS certification preferred.
  • 7+ years in Medicare Advantage risk adjustment, with at least 3 years in a plan-side role (not solely provider-side or vendor-side).
  • Direct, hands-on RADV experience - working fluency with the CMS-HCC model, including the  V24-V28  transition and its financial implications.
  • Demonstrated experience managing or transitioning RA vendors (coding, chart retrieval, in-home assessment).
  • Strong analytical skills: able to interrogate data directly in SQL, Power BI, or Tableau, or to spec analytics requirements with precision.+
  • Strong Microsoft Office skills (Word, Outlook, Excel and PP).


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