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 ...
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 ...
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 ...
Quick apply
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 ...
Manager, Risk Adjustment
Worcester, MA · On-site
$90K/yr
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 ...
Manager, Risk Adjustment
Worcester, MA · On-site
$90K/yr
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 ...
RN RT PT OT Director of Quality/Risk Management
Rochdale, MA · On-site
$50 - $60/hr
Functions as the Risk Manager for organization as well as the Facility Compliance Officer. Required ... Nursing, Physical Therapy, Occupational Therapy, Speech Language Pathology or Respiratory Therapy.
RN RT PT OT Director of Quality/Risk Management
Rochdale, MA · On-site
$50 - $60/hr
Functions as the Risk Manager for organization as well as the Facility Compliance Officer. Required ... Nursing, Physical Therapy, Occupational Therapy, Speech Language Pathology or Respiratory Therapy.
ROLE AND RESPONSIBILITIES Work with the Risk Management Team to complete Workers Compensation ... Work with insurance carriers on mitigating losses using investigators, nurse managers, and other ...
Quick apply
ROLE AND RESPONSIBILITIES Work with the Risk Management Team to complete Workers Compensation ... Work with insurance carriers on mitigating losses using investigators, nurse managers, and other ...
Quality Improvement Nurse
Worcester, MA · On-site
$100K - $111K/yr
The Quality Improvement Nurse provides clinical leadership to enhance patient care and safety by ... Develop and implement non-provider clinical support staff quality and risk management audits.
Quick apply
Quality Improvement Nurse
Worcester, MA · On-site
$100K - $111K/yr
The Quality Improvement Nurse provides clinical leadership to enhance patient care and safety by ... Develop and implement non-provider clinical support staff quality and risk management audits.
Workers Comp Claims Specialist - Corporate
Worcester, MA · On-site
$23.25 - $32/hr
ROLE AND RESPONSIBILITIES • Work with the Risk Management Team to complete Workers' Compensation ... nurse managers, and other tools available. Human Resources Department • Attend quarterly claim ...
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Workers Comp Claims Specialist - Corporate
Worcester, MA · On-site
$23.25 - $32/hr
ROLE AND RESPONSIBILITIES • Work with the Risk Management Team to complete Workers' Compensation ... nurse managers, and other tools available. Human Resources Department • Attend quarterly claim ...
Registered Nurse (RN) Manager
$110K - $115K/yr
Ensure Infection Control, Safety and Risk Management policies are consistently implemented on the unit. * Provide supervision and direction in accordance with Nursing Department's goals and ...
New
Registered Nurse (RN) Manager
$110K - $115K/yr
Ensure Infection Control, Safety and Risk Management policies are consistently implemented on the unit. * Provide supervision and direction in accordance with Nursing Department's goals and ...
New
Registered Nurse (RN) Manager
Worcester, MA · On-site
$110K - $115K/yr
Ensure Infection Control, Safety and Risk Management policies are consistently implemented on the unit. * Provide supervision and direction in accordance with Nursing Department's goals and ...
New
Registered Nurse (RN) Manager
Worcester, MA · On-site
$110K - $115K/yr
Ensure Infection Control, Safety and Risk Management policies are consistently implemented on the unit. * Provide supervision and direction in accordance with Nursing Department's goals and ...
New
Director Of Nursing
$110K - $137K/hr
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Collaborates closely with QA/QI/PI, Corporate Compliance & Risk Manager to plan, implement ...
Director Of Nursing
$110K - $137K/hr
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Collaborates closely with QA/QI/PI, Corporate Compliance & Risk Manager to plan, implement ...
Director Of Nursing
$110K - $137K/hr
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Collaborates closely with QA/QI/PI, Corporate Compliance & Risk Manager to plan, implement ...
Director Of Nursing
$110K - $137K/hr
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Collaborates closely with QA/QI/PI, Corporate Compliance & Risk Manager to plan, implement ...
Director Of Nursing
$110K - $137K/hr
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Collaborates closely with QA/QI/PI, Corporate Compliance & Risk Manager to plan, implement ...
Director Of Nursing
$110K - $137K/hr
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Collaborates closely with QA/QI/PI, Corporate Compliance & Risk Manager to plan, implement ...
Director Of Nursing
$110K - $137K/hr
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Collaborates closely with QA/QI/PI, Corporate Compliance & Risk Manager to plan, implement ...
Director Of Nursing
$110K - $137K/hr
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Collaborates closely with QA/QI/PI, Corporate Compliance & Risk Manager to plan, implement ...
Director Of Nursing
$110K - $137K/hr
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Collaborates closely with QA/QI/PI, Corporate Compliance & Risk Manager to plan, implement ...
Director Of Nursing
$110K - $137K/hr
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Collaborates closely with QA/QI/PI, Corporate Compliance & Risk Manager to plan, implement ...
Director Of Nursing
Leominster, MA · On-site
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Risk Manager to plan, implement, evaluation, and manage QI and PI projects over short and long ...
Director Of Nursing
Leominster, MA · On-site
... ) who is responsible for overseeing and managing all direct clinical operations of the health ... Risk Manager to plan, implement, evaluation, and manage QI and PI projects over short and long ...
"Endoscopy Nurse,GI Lab RN,Gastrointestinal Nurse"
$34.37 - $70.88/hr
The RN directs care according to established standards of safety, risk management, QI, and Infection Control, with the goal being to discharge the patient with an optimum level of care provided.
"Endoscopy Nurse,GI Lab RN,Gastrointestinal Nurse"
$34.37 - $70.88/hr
The RN directs care according to established standards of safety, risk management, QI, and Infection Control, with the goal being to discharge the patient with an optimum level of care provided.
The RN directs care according to established standards of safety, risk management, QI, and Infection Control, with the goal being to discharge the patient with an optimum level of care provided.
The RN directs care according to established standards of safety, risk management, QI, and Infection Control, with the goal being to discharge the patient with an optimum level of care provided.
The RN directs care according to established standards of safety, risk management, QI, and Infection Control, with the goal being to discharge the patient with an optimum level of care provided.
The RN directs care according to established standards of safety, risk management, QI, and Infection Control, with the goal being to discharge the patient with an optimum level of care provided.
The RN directs care according to established standards of safety, risk management, QI, and Infection Control, with the goal being to discharge the patient with an optimum level of care provided.
The RN directs care according to established standards of safety, risk management, QI, and Infection Control, with the goal being to discharge the patient with an optimum level of care provided.
The RN directs care according to established standards of safety, risk management, QI, and Infection Control, with the goal being to discharge the patient with an optimum level of care provided.
The RN directs care according to established standards of safety, risk management, QI, and Infection Control, with the goal being to discharge the patient with an optimum level of care provided.
Nurse Risk Manager information
See Rutland, MA salary details
$54.4K - $65.7K
4% of jobs
$65.7K - $77.1K
6% of jobs
$77.1K - $88.5K
11% of jobs
$92.7K is the 25th percentile. Wages below this are outliers.
$88.5K - $99.8K
11% of jobs
The median wage is $108.9K / yr.
$99.8K - $111.2K
23% of jobs
$111.2K - $122.6K
13% of jobs
$130.1K is the 75th percentile. Wages above this are outliers.
$122.6K - $133.9K
12% of jobs
$133.9K - $145.3K
8% of jobs
$145.3K - $156.7K
6% of jobs
$156.7K - $168.1K
4% of jobs
$168.1K - $179.4K
2% of jobs
$54.4K
$117.7K
$179.4K
How much do nurse risk manager jobs pay per year?
What is a Nurse Risk Manager?
What is the difference between Nurse Risk Manager vs Nurse Safety Coordinator?
| Aspect | Nurse Risk Manager | Nurse Safety Coordinator |
|---|---|---|
| Certifications | RN license, risk management certifications | RN license, safety certifications |
| Work Environment | Hospitals, healthcare facilities, risk departments | Hospitals, clinics, safety departments |
| Primary Focus | Risk mitigation, legal compliance, incident investigation | Workplace 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?
What are some common challenges faced by Nurse Risk Managers when balancing patient care and regulatory compliance?

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.Â
* 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.Â
- 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).
About Mass Advantage
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
51 - 200 Employees
Headquarters location
Worcester, MA, US
Year founded
2021