Conduct compliance risk assessments related to coding, documentation, and encounter data ... Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits ...
Conduct compliance risk assessments related to coding, documentation, and encounter data ... Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits ...
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding ... HCC models, RADV, quality programs, value-based care, and the competitive landscape) to engage ...
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding ... HCC models, RADV, quality programs, value-based care, and the competitive landscape) to engage ...
CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization management, care management, medical economics) * Proven experience managing complex, multi-stakeholder ...
CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization management, care management, medical economics) * Proven experience managing complex, multi-stakeholder ...
Medical Director, Population Health
Chicago, IL · On-site
$170 - $185/hr
Meaningful experience in risk adjustment (HCC/RAF), Stars/HEDIS, and/or chronic condition ... Flexible hybrid work model, with preference for candidates who can work in‑person 1-2 days per ...
Medical Director, Population Health
Chicago, IL · On-site
$170 - $185/hr
Meaningful experience in risk adjustment (HCC/RAF), Stars/HEDIS, and/or chronic condition ... Flexible hybrid work model, with preference for candidates who can work in‑person 1-2 days per ...
Head of Medicare Performance Hub
Chicago, IL · On-site
$198 - $278/hr
CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization management, care management, medical economics) * Proven experience managing complex, multi-stakeholder ...
New
Head of Medicare Performance Hub
Chicago, IL · On-site
$198 - $278/hr
CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization management, care management, medical economics) * Proven experience managing complex, multi-stakeholder ...
New
Physical Therapist Per Diem
Oak Park, IL · On-site
$55/hr
Restricted Part Time / Per Diem (Total FTE .10) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4 ... Code of Ethics and state licensure laws. • Based on the patient's cognitive, physical and ...
Physical Therapist Per Diem
Oak Park, IL · On-site
$55/hr
Restricted Part Time / Per Diem (Total FTE .10) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4 ... Code of Ethics and state licensure laws. • Based on the patient's cognitive, physical and ...
Physical Therapist Per Diem
Oak Park, IL · On-site
$55/hr
Restricted Part Time / Per Diem (Total FTE. 10) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4 ... Code of Ethics and state licensure laws. • Based on the patient's cognitive, physical and ...
Physical Therapist Per Diem
Oak Park, IL · On-site
$55/hr
Restricted Part Time / Per Diem (Total FTE. 10) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4 ... Code of Ethics and state licensure laws. • Based on the patient's cognitive, physical and ...
Physical Therapist Per Diem
Oak Park, IL · On-site
$55/hr
Restricted Part Time / Per Diem (Total FTE .10) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4 ... Code of Ethics and state licensure laws. • Based on the patient's cognitive, physical and ...
Physical Therapist Per Diem
Oak Park, IL · On-site
$55/hr
Restricted Part Time / Per Diem (Total FTE .10) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4 ... Code of Ethics and state licensure laws. • Based on the patient's cognitive, physical and ...
Physician Assistant or Nurse Practitioner - Thoracic Surgery, Quality, Clinical Documentation (Ou...
Chicago, IL · On-site
CPT coding for thoracic surgical procedures * Elixhauser and Charlson comorbidity indices * CMS Star Rating, Leapfrog Hospital Safety Grade, AHRQ PSIs, and CMS HACs * CMS-HCC and Risk Adjustment ...
Physician Assistant or Nurse Practitioner - Thoracic Surgery, Quality, Clinical Documentation (Ou...
Chicago, IL · On-site
CPT coding for thoracic surgical procedures * Elixhauser and Charlson comorbidity indices * CMS Star Rating, Leapfrog Hospital Safety Grade, AHRQ PSIs, and CMS HACs * CMS-HCC and Risk Adjustment ...
Physician Assistant or Acute Care Nurse Practitioner - Thoracic Surgery, Quality, Clinical Docume...
CPT coding for thoracic surgical procedures * Elixhauser and Charlson comorbidity indices * CMS Star Rating, Leapfrog Hospital Safety Grade, AHRQ PSIs, and CMS HACs * CMS-HCC and Risk Adjustment ...
Physician Assistant or Acute Care Nurse Practitioner - Thoracic Surgery, Quality, Clinical Docume...
CPT coding for thoracic surgical procedures * Elixhauser and Charlson comorbidity indices * CMS Star Rating, Leapfrog Hospital Safety Grade, AHRQ PSIs, and CMS HACs * CMS-HCC and Risk Adjustment ...
Director, Coding
Chicago, IL · Remote
Must be Certified Coder (AAPC or AHIMA) * Experience with encoders and computerized abstracting ... Knowledge and experience of Medicare Risk Adjustment guidelines
Director, Coding
Chicago, IL · Remote
Must be Certified Coder (AAPC or AHIMA) * Experience with encoders and computerized abstracting ... Knowledge and experience of Medicare Risk Adjustment guidelines
Audiologist - Per Diem
Plainfield, IL · On-site
$38.67 - $59.94/hr
Per Diem * Hours: As needed, Monday - Friday, 8am - 6pm * Required Travel: Yes 24600 W 127th Street ... Provide hearing aid adjustments and cleanings as requested. * Maintain current "state of the art" ...
New
Audiologist - Per Diem
Plainfield, IL · On-site
$38.67 - $59.94/hr
Per Diem * Hours: As needed, Monday - Friday, 8am - 6pm * Required Travel: Yes 24600 W 127th Street ... Provide hearing aid adjustments and cleanings as requested. * Maintain current "state of the art" ...
New
Deep familiarity with Medicare Advantage program structure, including CMS Star Ratings, Risk Adjustment (RAF/HCC), and medical cost management strategies; knowledge of FEHBP and FEP program structure ...
Deep familiarity with Medicare Advantage program structure, including CMS Star Ratings, Risk Adjustment (RAF/HCC), and medical cost management strategies; knowledge of FEHBP and FEP program structure ...
HCC
Merrillville, IN · On-site
Join our growing team as a Hospice Care Consultant (HCC) - a strategic sales representative who ... Per Diem): * Competitive Pay * 401(k) with Company Match * Career Advancement Opportunities
HCC
Merrillville, IN · On-site
Join our growing team as a Hospice Care Consultant (HCC) - a strategic sales representative who ... Per Diem): * Competitive Pay * 401(k) with Company Match * Career Advancement Opportunities
HCC
Arlington Heights, IL · On-site
Join our growing team as a Hospice Care Consultant (HCC) - a strategic sales representative who ... Per Diem): * Competitive Pay * 401(k) with Company Match * Career Advancement Opportunities
HCC
Arlington Heights, IL · On-site
Join our growing team as a Hospice Care Consultant (HCC) - a strategic sales representative who ... Per Diem): * Competitive Pay * 401(k) with Company Match * Career Advancement Opportunities
Audiologist - Per Diem
Naperville, IL · On-site
$38.67 - $59.94/hr
Per Diem * Hours: As needed, Monday - Friday, 8am - 6pm * Required Travel: Yes 24600 W 127th Street ... Provide hearing aid adjustments and cleanings as requested. * Maintain current "state of the art" ...
Audiologist - Per Diem
Naperville, IL · On-site
$38.67 - $59.94/hr
Per Diem * Hours: As needed, Monday - Friday, 8am - 6pm * Required Travel: Yes 24600 W 127th Street ... Provide hearing aid adjustments and cleanings as requested. * Maintain current "state of the art" ...
Audiologist - Per Diem
Naperville, IL · On-site
$38.67 - $59.94/hr
Per Diem * Hours: As needed, Monday - Friday, 8am - 6pm * Required Travel: Yes 24600 W 127th Street ... Provide hearing aid adjustments and cleanings as requested. * Maintain current "state of the art" ...
Audiologist - Per Diem
Naperville, IL · On-site
$38.67 - $59.94/hr
Per Diem * Hours: As needed, Monday - Friday, 8am - 6pm * Required Travel: Yes 24600 W 127th Street ... Provide hearing aid adjustments and cleanings as requested. * Maintain current "state of the art" ...
Cytologist - Per Diem
$35.16 - $54.50/hr
Position: Cytologist - Per Diem * Location: Swedish Hospital * Full Time/Part Time: Per Diem ... Correctly identify abnormal or high-risk cases, referring them to the Clinical Pathologist as ...
New
Cytologist - Per Diem
$35.16 - $54.50/hr
Position: Cytologist - Per Diem * Location: Swedish Hospital * Full Time/Part Time: Per Diem ... Correctly identify abnormal or high-risk cases, referring them to the Clinical Pathologist as ...
New
Cytologist - Per Diem * Location: Northwest Community Hospital * Full Time/Part Time: Per Diem ... Correctly identify abnormal or high-risk cases, referring them to the Clinical Pathologist as ...
Posted today
Cytologist - Per Diem * Location: Northwest Community Hospital * Full Time/Part Time: Per Diem ... Correctly identify abnormal or high-risk cases, referring them to the Clinical Pathologist as ...
Posted today
Per Diem Pharmacy Technician - Palatine, IL
Palatine, IL · On-site
$17 - $26/hr
This per diem position requires licensed Illinois Pharmacy Technicians ready to contribute in a ... Maintain compliance with facility dress code and professional appearance guidelines Qualifications ...
New
Per Diem Pharmacy Technician - Palatine, IL
Palatine, IL · On-site
$17 - $26/hr
This per diem position requires licensed Illinois Pharmacy Technicians ready to contribute in a ... Maintain compliance with facility dress code and professional appearance guidelines Qualifications ...
New
Per Diem Hcc Risk Adjustment Coder information
See Chicago, IL salary details
$16.34 - $18.08
6% of jobs
$19.31 is the 25th percentile. Wages below this are outliers.
$18.08 - $19.81
26% of jobs
The median wage is $20.80 / hr.
$19.81 - $21.54
31% of jobs
$21.54 - $23.28
7% of jobs
$24.01 is the 75th percentile. Wages above this are outliers.
$23.28 - $25.01
11% of jobs
$25.01 - $26.74
6% of jobs
$26.74 - $28.48
5% of jobs
$28.48 - $30.21
3% of jobs
$30.21 - $31.94
2% of jobs
$31.94 - $33.68
1% of jobs
$33.68 - $35.41
1% of jobs
$16
$23
$35
How much do per diem hcc risk adjustment coder jobs pay per hour?
$75K - $165K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 20 days ago
CVS Health rating
5.8
Based on 4,332 frontline employees who took The Breakroom Quiz
89th of 112 rated pharmacies
Job description
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position Summary
As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.
The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.
Key Responsibilities
Lead the Medicare Advantage Risk Adjustment compliance program.
Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.
Assess operational processes for compliance risks related to risk adjustment activities.
Develop and implement corrective action plans for identified compliance issues.
Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.
Required Qualifications
Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance
Minimum 5 years in a leadership role
One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)
Willingness to travel up to 10% (including by plane)
Preferred Qualifications
Health Information Management (RHIA/RHIT)
Nursing - Strong understanding of clinical documentation and medical record review
Certified Risk Adjustment Coder (CRC) with compliance experience
Provider coding audit/compliance leadership experience
Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits
Education
Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.
Pay Range
The typical pay range for this role is:
$75,400.00 - $165,954.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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About CVS Health
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Industry
Health care and social assistance and retail
Company size
10,000+ Employees
Headquarters location
Woonsocket, RI, US