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Remote Hcc Risk Adjustment Coder Jobs in Colorado

DaVita, Inc.

Director, Product Value Based Care

Denver, CO · On-site +1

$239K - $251K/yr

We prefer a hybrid schedule, but are open to fully remote candidates. At DaVita, we are building an ... and/or risk adjustment. * Strategic Communication: Exceptional ability to synthesize complex ...

Quantix

C# Application Security Architect

Englewood, CO · Remote

... remote development teams. 2) 5-7 years of Application security and secure coding experience ... risk management domains such as but not limited to: application security, infrastructure security ...

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Remote Hcc Risk Adjustment Coder information

What is a Remote HCC Risk Adjustment Coder?

A Remote HCC Risk Adjustment Coder is a medical coding professional who works from home or another remote location, reviewing patient medical records to assign Hierarchical Condition Category (HCC) codes. These codes are used by healthcare organizations to accurately reflect the severity of patient illnesses for risk adjustment and reimbursement purposes, especially in Medicare Advantage programs. The coder analyzes clinical documentation to ensure that diagnoses are coded correctly and in compliance with regulatory guidelines. Their work is essential for ensuring healthcare providers receive appropriate compensation and for maintaining accurate patient risk profiles.

What are the key skills and qualifications needed to thrive as a remote HCC risk adjustment coder?

To thrive as a Remote HCC Risk Adjustment Coder, you need a solid understanding of ICD-10-CM coding guidelines, risk adjustment models, and extensive experience in medical record review, typically supported by a relevant coding certification such as CPC or CRC. Proficiency with electronic health record (EHR) systems, coding software, and risk adjustment platforms is essential. Exceptional attention to detail, analytical thinking, and strong communication skills help coders excel in remote settings and ensure coding accuracy. These skills and qualifications are vital for optimizing risk scores, ensuring compliance, and supporting accurate reimbursement in healthcare organizations.

What are some common challenges faced by remote HCC risk adjustment coders and how can they be managed?

Remote HCC Risk Adjustment Coders often encounter challenges such as interpreting incomplete or ambiguous medical documentation, staying updated with evolving coding guidelines, and managing communication across dispersed teams. To address these challenges, it's important to proactively seek clarification from providers, participate in ongoing training, and utilize collaboration tools to stay connected with peers and supervisors. Establishing a structured daily workflow and leveraging available resources can also help maintain coding accuracy and productivity in a remote setting.

What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Colorado?

The most popular types of Hcc Risk Adjustment Coder jobs in Colorado are:

What are popular job titles related to Remote Hcc Risk Adjustment Coder jobs in Colorado?

For Remote Hcc Risk Adjustment Coder jobs in Colorado, the most frequently searched job titles are:

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Remote Hcc Risk Adjustment Coder jobs near you
Infographic showing various Remote Hcc Risk Adjustment Coder job openings in Colorado as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 10% Part Time, and 3% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution.

Program Manager, Risk Adjustment & Stars

Alpine Physician Partners

Denver, CO

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 8 days ago

Job description

Are you looking to work for a company that has been recognized for over a decade as a Top Place to Work? Apply today to become a part of a company that continues to commit to putting our employees first.
Job Description:
OVERVIEW OF POSITION:
The Program Manager, Risk Adjustment & Stars, serves as the connective link between Alpine's technical teams (coding, data, analytics, IT) and its operational and business stakeholders (leadership, quality, health plan operations) for risk adjustment and Star Ratings performance. This role translates technical details, such as data pipelines, coding logic, and CMS methodology, into operational plans, priorities, and decisions, while ensuring operational requirements and business goals are reflected back into the technical work. The role does not require direct provider-facing engagement.
ESSENTIAL DUTIES:
Program Management
  • Owns the annual risk adjustment and Stars improvement program cycle, coordinating between technical teams and operational/business stakeholders across prospective and retrospective programs, visit-based campaigns, and gap closure workflows.
  • Builds and manages program timelines and throughput; reports progress to Alpine leadership and health plan partners in clear, business-friendly terms.
  • Leads cross-functional workgroups spanning coding/HCC teams, clinical quality, IT, and analytics, ensuring technical work stays aligned to operational priorities.
  • Manages program-level documentation and requirements, translating between technical specifications and operational plans.
Risk Adjustment
  • Acts as the liaison between coding/data teams and operational stakeholders on HCC capture workflows, chart review pipelines, and gap identification, ensuring both sides understand priorities and constraints.
  • Manages relationships with vendors, coordinating technical file exchange and integration needs with operational timelines and expectations.
  • Monitors RAF score trends and performance results, working with analytics teams to interpret findings and translates them into operational action plans.
  • Coordinates risk adjustment data submission accuracy and reconciliation (EDS), connecting technical issue resolution with business and health plan deadlines.
  • Tracks HCC model version transitions (e.g., CMS-HCC V24/V28) and communicates their operational and financial impact to leadership and business teams.
Stars & Quality
  • Coordinates Alpine's Star Ratings strategy across HEDIS, CAHPS, HOS, and medication adherence measures, connecting technical measure logic with operational execution.
  • Partners with analytics teams to maintain measure-level performance tracking and cut-point modeling, translating results into operational priorities and gap closure plans.
  • Serves as one point of contact for Alpine with health plan Stars/quality teams, bridging technical data exchange requirements with operational and contractual needs.
Analytics & Reporting
  • Partners with analytics and data teams to define KPIs and dashboards for RAF accuracy, coding gap closure rates, and Star measure performance, ensuring outputs are operationally useful.
  • Translates CMS methodology updates (HCC model version changes, Star Ratings technical notes, measure weighting changes) for both technical teams (as specifications) and operational teams (as business impact).
  • Helps identify and escalate data integrity issues across source systems (claims, EHR, supplemental data feeds), coordinating resolution between technical and operational owners.
  • Presents performance results and program recommendations to Alpine executive leadership and payer partners.
Compliance & Governance
  • Ensures all program activities comply with CMS regulations, ICD-10-CM coding guidelines, and Alpine's compliance policies.
  • Supports RADV audit readiness and health plan data validation requests, coordinating between technical teams pulling data and operational/compliance teams managing the response.

EDUCATION:
Bachelor's degree in health informatics, data analytics, healthcare administration, business, or related field (Master's preferred).
EXPERIENCE:
Five (5) to seven (7) years of experience in Medicare Advantage risk adjustment and/or Star Ratings/quality improvement, ideally within a value-based care (VBC) setting.
Preferred Qualifications
• Certified Risk Adjustment Coder (CRC) credential.
• Experience with value-based care, ACOs, or delegated risk arrangements.
• Familiarity with multiple health plan Stars/quality programs and data exchange requirements.
• PMP or similar certification.
KNOWLEDGE, SKILLS, ABILITIES:
  • Working knowledge of CMS HCC risk adjustment models, RAF score methodology, EDS submission processes, and Star Ratings measure specifications.
  • Demonstrated ability to work effectively with both technical teams (data, analytics, IT) and operational/business stakeholders, translating between the two.
  • Proven program/project management experience managing cross-functional initiatives involving both technical and operational workstreams.
  • Working proficiency in Excel required; familiarity with SQL, Tableau, Power BI, or similar tools a plus.
  • Strong written and verbal communication skills, with the ability to translate technical and regulatory detail for operational and executive audiences.
  • Skilled at translating between technical and operational audiences, comfortable in both worlds without needing to be a deep technical expert.
  • Strong relationship management and cross-functional collaboration skills.
  • Analytical and detail-oriented, able to interpret data and technical findings and turn them into operational plans.
  • Adaptable to evolving CMS methodology and health plan requirements.
    • Able to travel to meetings
    • Ability to handle multiple demands concurrently in a high stress environment; organize, coordinate, set priorities and meet deadlines
    • Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures

Salary Range:
Salary Range: $83,990.40-$119,974.40
Additional Compensation: Eligible for annual bonus based on individual and/or company performance.
Benefits: Includes medical, dental, and vision insurance; 401(k); paid time off (PTO); and Employee Assistance Program (EAP)
Application Deadline: Open until filled. Applications will be reviewed on a rolling basis.
How to Apply: Apply via careers page at https://alpinephysicians.wd1.myworkdayjobs.com/external

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