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Product Manager Risk Adjustment Jobs (NOW HIRING)

CommunityCare, Inc.

Meet daily and weekly productivity goals and quality standards set by the supervisor. * Perform ... Bachelor's degree in Health Information Management or related field preferred. * Previous auditing ...

New

Viva Health

Risk Adjustment Specialist

Birmingham, AL · On-site

$92K/yr

This position will assist the Manager of Risk Adjustment with other projects as needed. Why VIVA HEALTH? VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is ...

CoxHealth

WI · On-site

This manager will work with other staff and leaders within CHP to ensure risk-adjusted revenue matches members actual health status. Comprehensively understands financial side of risk adjustment ...

New

VIVA Health

Risk Adjustment Specialist

Birmingham, AL

$92K/yr

This position will assist the Manager of Risk Adjustment with other projects as needed. Why VIVA HEALTH? VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is ...

DaMar Staffing

Risk Adjustment Coder

Virginia Beach, VA · On-site

$10K/mo

Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits ... management, accounting, finance, or other related field with 2 years of medical coding experience.

Viva Health

Risk Adjustment Specialist

Birmingham, AL · On-site

$92K/yr

This position will assist the Manager of Risk Adjustment with other projects as needed. Why VIVA HEALTH? VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is ...

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Product Manager Risk Adjustment information

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$51.5K

$159.4K

$197K

How much do product manager risk adjustment jobs pay per year?

As of Sep 14, 2026, the average yearly pay for product manager risk adjustment in the United States is $159,405.00, according to ZipRecruiter salary data. Most workers in this role earn between $141,000.00 and $197,000.00 per year, depending on experience, location, and employer.

What is a product manager risk adjustment?

A Product Manager Risk Adjustment is a professional responsible for overseeing products and solutions related to risk adjustment in healthcare, particularly for insurance and value-based care programs. They coordinate the development, implementation, and optimization of tools that help healthcare organizations accurately capture patient risk and ensure proper reimbursement. This role involves working with cross-functional teams, analyzing data, and staying compliant with regulatory requirements. Product Managers in this field play a crucial role in aligning company offerings with evolving healthcare policies and payer requirements.

How does a product manager risk adjustment typically collaborate with clinical and technical teams to improve product outcomes?

As a Product Manager for Risk Adjustment, you will often serve as a bridge between clinical experts, data analysts, and engineering teams. You'll facilitate regular meetings to align on priorities, clarify requirements, and translate complex healthcare regulations into actionable product features. Effective collaboration requires strong communication skills and the ability to manage input from multiple stakeholders, ensuring that risk adjustment solutions are both compliant and user-friendly. This cross-functional teamwork is critical for delivering products that accurately capture patient risk and support organizational objectives.

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

To thrive as a Product Manager Risk Adjustment, you need a solid understanding of healthcare risk adjustment methodologies, data analysis, and product lifecycle management, usually supported by a degree in business, healthcare, or a related field. Familiarity with risk adjustment software, data analytics tools like SQL or Tableau, and knowledge of CMS guidelines or HCC coding is highly valuable. Strong communication, problem-solving, and cross-functional collaboration skills help you bridge the gap between technical teams and business stakeholders. These competencies enable you to develop effective risk adjustment solutions that ensure regulatory compliance and drive organizational success in the evolving healthcare landscape.

What is the difference between Product Manager Risk Adjustment vs Product Manager Healthcare Data?

AspectProduct Manager Risk AdjustmentProduct Manager Healthcare Data
Required CredentialsHealthcare certifications, data analysis skillsData analysis, healthcare informatics certifications
Work EnvironmentInsurance companies, healthcare plansHealthcare providers, health tech companies
Employer & Industry UsageFocus on risk models, reimbursement accuracyFocus on data management, analytics

Product Manager Risk Adjustment primarily concentrates on developing and managing models to accurately predict healthcare costs for reimbursement, often within insurance companies. In contrast, Product Manager Healthcare Data focuses on managing healthcare data systems and analytics to improve patient outcomes and operational efficiency. While both roles require healthcare knowledge and data skills, their core objectives and work environments differ significantly.

What are popular job titles related to Product Manager Risk Adjustment jobs?

For Product Manager Risk Adjustment jobs, the most frequently searched job titles are:

Infographic showing various Product Manager Risk Adjustment job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 11% Part Time, and 1% Contract. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $159,405 per year, or $76.6 per hour.

Risk Adjustment - Risk Adjustment Auditor 135-2032

On-site

CommunityCare, Inc.
See more jobs at CommunityCare, Inc.external

Other

Posted 3 days ago

New

Job description

Tulsa, OK, USA

Job Description

Posted Tuesday, September 8, 2026 at 6:00 AM

JOB SUMMARY:
The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity.

KEY RESPONSIBILITIES
  • Perform bi-directional retrospective and prospective medical record reviews to validate, clarify, and accurately capture risk adjusted diagnoses (HCCs) in accordance with CMS guidelines and MEAT documentation requirements.
  • Ensure documentation supports coded conditions in accordance with ICD-10-CM, CMS, and payer-specific guidelines.
  • Identify unsupported diagnoses, over coding, under-coding, and documentation gaps.
  • Provide detailed audit findings and recommendations to coding teams, providers, and leadership.
  • Monitor compliance with CMS Risk Adjustment Data Validation (RADV) standards.
  • Track and report audit results, trends, and performance metrics.
  • Collaborate with coding staff, providers, and operations teams to improve documentation quality and coding accuracy.
  • Assist with education and training initiatives related to risk adjustment and documentation best practices.
  • Maintain confidentiality and ensure compliance with HIPAA regulations.
  • Meet daily and weekly productivity goals and quality standards set by the supervisor.
  • Perform other job-related duties as required or assigned.
QUALIFICATIONS
  • Knowledge of CMS-HCC and HHS-HCC risk adjustment model.
  • Knowledge of ICD-10-CM coding guidelines.
  • Knowledge of RADV requirements.
  • Proficiency in EMR systems and Microsoft Office (Excel preferred).
  • High attention to detail.
  • Strong analytical and critical thinking skills.
  • Clear written and verbal communication.
  • Ability to work independently and meet deadlines.
  • Strong organizational skills.
  • Integrity and commitment to compliance.
  • Successful completion of Health Care Sanctions background check.
EDUCATION/EXPERIENCE
  • A minimum of two years of risk adjustment coding or auditing experience.
  • Experience reviewing medical records across multiple specialties.
  • Certified Professional Coder (CPC), CRC, CCS, or equivalent coding certification.
  • Bachelor’s degree in Health Information Management or related field preferred.
  • Previous auditing experience in Medicare Advantage and ACA preferred.
  • Experience with internal audit programs or payer audits preferred.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin

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