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Remote Flexible Risk Adjustment Coder Jobs in Maine

NinjaOne

Location - We are flexible on remote working from home, if you are located in the USA and reside in ... Provide subject matter expertise in code reviews, integration, and deployment events. Lead the ...

NinjaOne

Location - We are flexible on remote working from home, if you are located in the USA and reside in ... Committing Code and Shipping Products - you will be one of our most trusted engineers committing ...

NinjaOne

Location - We are flexible on remote working from home, if you are located in the USA and reside in ... code. * Proven ability to take product features from idea to delivery and iterate based on customer ...

New

Wood Plc

Water Resources Engineer

Portland, ME · Remote

$80K - $110K/yr

... resources, flood risk management and environmental restoration projects #LI-Remote Skills ... Capability to work in a dynamic environment, including a demonstrated willingness to be flexible ...

NinjaOne

... risk exposure, support compliance obligations, and advance the organization's overall security maturity. Location  - We are flexible on remote working from home, if you are located in ...

NinjaOne

Location - We are flexible on remote working from home, if you are located in the USA and reside in ... Experience with cloud automation and infrastructure-as-code (IaC) toolsets, primarily ...

NinjaOne

$124K - $159K/yr

... as Code (IaC), and scalable build systems. In this role, you will lead a high-impact team ... Location - We are flexible on remote working from home, if you are located in the USA and reside in ...

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All JobsRisk Adjustment Coder JobsRemote Flexible Risk Adjustment Coder JobsRemote Flexible Risk Adjustment Coder Jobs in Maine

Remote Flexible Risk Adjustment Coder information

What are the key skills and qualifications needed to thrive as a Remote Flexible Risk Adjustment Coder, and why are they important?

To thrive as a Remote Flexible Risk Adjustment Coder, you need a strong grasp of medical coding standards (ICD-10-CM), risk adjustment models, and a certification such as CPC, CRC, or CCS. Proficiency with coding software, EHR systems, and secure remote communication tools is typically required. Attention to detail, time management, and strong analytical and communication skills help ensure accuracy and effective remote collaboration. These skills are vital for precise coding, regulatory compliance, and supporting accurate healthcare reimbursements in a remote work environment.

What is the difference between Remote Flexible Risk Adjustment Coder vs Remote Risk Adjustment Coder?

AspectRemote Flexible Risk Adjustment CoderRemote Risk Adjustment Coder
CertificationsAHIMA or AAPC certifications, CPC or CCSSame certifications as flexible role
Work EnvironmentFlexible hours, remote workPrimarily remote, with some flexibility
Employer UsageHealth plans, insurance companies, healthcare providersSimilar employer types, often overlapping
Search IntentFlexible scheduling, remote work optionsGeneral risk adjustment coding roles

The Remote Flexible Risk Adjustment Coder offers more scheduling flexibility compared to the standard Remote Risk Adjustment Coder, while both roles require similar credentials and are used in comparable healthcare settings. The flexible role is ideal for those seeking adaptable hours within the same industry.

How does a Remote Flexible Risk Adjustment Coder typically collaborate with healthcare providers and other coding professionals?

As a Remote Flexible Risk Adjustment Coder, collaboration often occurs through secure digital platforms, regular virtual meetings, and shared documentation tools. You may work closely with healthcare providers to clarify medical records and ensure coding accuracy, as well as coordinate with other coders to maintain consistency and compliance. Strong communication skills and responsiveness are essential, as much of the interaction is asynchronous and relies on clear documentation. This teamwork helps ensure accurate risk adjustment coding, supporting healthcare organizations in meeting regulatory and reimbursement standards.

What is a Remote Flexible Risk Adjustment Coder?

A Remote Flexible Risk Adjustment Coder is a healthcare professional who reviews and assigns diagnostic codes to patient records from a remote location, often with flexible hours. Their main role is to ensure that medical diagnoses are accurately captured for risk adjustment purposes, which helps healthcare organizations receive appropriate reimbursement from insurers. They typically analyze electronic health records, identify relevant conditions, and code them based on established guidelines. This job requires knowledge of medical terminology, coding systems like ICD-10, and a strong attention to detail. Working remotely allows for a flexible schedule, making it a popular option for experienced coders.
What are popular job titles related to Remote Flexible Risk Adjustment Coder jobs in Maine? For Remote Flexible Risk Adjustment Coder jobs in Maine, the most frequently searched job titles are:
What job categories do people searching Remote Flexible Risk Adjustment Coder jobs in Maine look for? The top searched job categories for Remote Flexible Risk Adjustment Coder jobs in Maine are:
What cities in Maine are hiring for Remote Flexible Risk Adjustment Coder jobs? Cities in Maine with the most Remote Flexible Risk Adjustment Coder job openings:
Remote Flexible Risk Adjustment Coder jobs near you
REMOTE - Vice President Medical Director of Clinical Programs

REMOTE - Vice President Medical Director of Clinical Programs

Martin's Point Health Care

Portland, ME • On-site, Remote

Full-time

Medical, Vision

Posted 10 days ago

Martin’s Point Health Care rating

7.4

Company rating: 7.4 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

Job description

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.
Position Summary
The Vice President, Medical Director, Health Plan provides senior clinical leadership across the Health Plan, with a focus on quality, affordability, compliance, clinical performance, and member outcomes. This role requires strong health plan experience, the ability to lead across functions, and the communication skills to influence clinical, operational, financial, regulatory, and executive stakeholders.
Job Description
Employees are expected to support and demonstrate the mission, vision, and core values of Martin's Point Health Care.
Key responsibilities include:
  • Partner with Health Plan senior leadership to advance clinical outcomes, affordability goals, growth targets, and overall health plan strategy.
  • Provide clinical leadership across utilization management, care management, population health, quality, pharmacy, medical policy, payment policy, and clinical program development.
  • Lead cross-functional collaboration among Medical Directors, Medical Economics, Quality, Network, Compliance, Pharmacy, Operations, and Clinical Programs.
  • Support compliance with government program requirements, including clinical appeals and grievances, using sound clinical evidence and medical judgment.
  • Use clinical, quality, utilization, and financial data to identify trends, assess performance, and recommend actionable interventions.
  • Develop strategies to improve medical expense management, appropriate utilization, quality of care, and population health outcomes.
  • Provide clinical input into product design, Medicare bids, risk adjustment, STARS, HEDIS, value-based arrangements, and clinical integration initiatives.
  • Communicate complex clinical, regulatory, and operational information clearly to executive, provider, clinical, and non-clinical audiences.
  • Support appropriate utilization of services through strong partnership with Utilization Management, Care Management, and physician leaders.
  • Represent the organization with regulatory entities, professional societies, providers, network partners, and external stakeholders, as appropriate.
  • Build and strengthen relationships with hospitals, physicians, and other health care providers to support network engagement and performance goals.
  • Support strategies tied to population health, care management, provider performance, and contractual outcomes.
  • Lead, support, and develop physician leaders and clinical team members, as assigned.
Position Qualifications
Required
  • Medical Degree, MD or DO, from an accredited medical school.
  • Board certification in a relevant medical discipline or specialty.
  • Active, unrestricted medical license, or ability to obtain licensure in a state relevant to the role.
  • Ten or more years of professional experience, including clinical practice experience.
  • Health plan, managed care, or payer experience in a Medical Director or comparable physician leadership role.
  • Demonstrated experience working across health plan functions, such as utilization management, care management, quality, appeals and grievances, population health, medical economics, provider relations, pharmacy, compliance, or network.
  • Experience using clinical, quality, utilization, or financial data to guide decisions, develop interventions, and measure outcomes.
  • Strong cross-functional leadership skills, with the ability to align clinical, operational, financial, and regulatory priorities.
  • Strong verbal, written, and presentation skills, including the ability to communicate effectively with executive, clinical, provider, operational, and regulatory audiences.
  • Ability to influence, collaborate, and build credibility with internal and external stakeholders.
  • Strong analytical, problem-solving, and decision-making skills.
  • Demonstrated alignment with Martin's Point Health Care values.
Preferred
  • Experience with Medicare Advantage, TRICARE, or other government-sponsored programs.
  • Experience with STARS, RAF, risk adjustment, Medicare bids, HEDIS, or value-based care arrangements.
  • Prior management or physician leadership experience.
  • Experience supporting medical policy, payment policy, pharmacy, or clinical program development.
  • Experience building relationships with network physicians, hospitals, and community providers.

This position is not eligible for immigration sponsorship.
We are an equal opportunity/affirmative action employer.
Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact jobinquiries@martinspoint.org
Do you have a question about careers at Martin's Point Health Care? Contact us at: jobinquiries@martinspoint.org

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