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Remote Hcc Risk Adjustment Jobs in Philadelphia, PA

Ennoble Care

Actuary

Philadelphia, PA · Remote

$150/hr

Ennoble Care offers a variety of programs including, remote patient monitoring, behavioral health ... Thorough understanding of and hands-on experience with Medicare risk adjustment and CMS-HCC models

Ennoble Care

Actuary

Marlton, NJ · Remote

$150/hr

Ennoble Care offers a variety of programs including, remote patient monitoring, behavioral health ... Thorough understanding of and hands-on experience with Medicare risk adjustment and CMS-HCC models

Monogram Health

Market Physician Executive

Trenton, NJ · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

This position will be remote within the designated market with occasional in-home patient treatment ... risk adjustment. * Current state medical license without restrictions to practice and free of ...

Corvel

Workers' Compensation Claims Specialist

Norristown, PA · Remote

$51K - $83K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives Workers' Compensation ... The level may impact the salary range and these adjustments would be clarified during the offer ...

Wider Circle

Care Advocate - Care Delivery

Philadelphia, PA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Execute person-centered care plans for patients with serious, high-risk illnesses. Assist in ... Remote Independence: Successfully work in a remote team environment with high independence and ...

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All JobsHcc Risk Adjustment JobsRemote Hcc Risk Adjustment JobsRemote Hcc Risk Adjustment Jobs in Philadelphia, PA

Remote Hcc Risk Adjustment information

What is the difference between Remote Hcc Risk Adjustment vs Remote Medical Coder?

AspectRemote Hcc Risk AdjustmentRemote Medical Coder
CertificationsHCC Certification, CPC or CCSCPC, CCS, or RHIT
Work EnvironmentHealthcare insurance, risk adjustment teamsMedical facilities, billing departments
Industry UsageHealth plans, Medicare/MedicaidHospitals, clinics, billing companies

Remote Hcc Risk Adjustment specialists focus on analyzing patient data to optimize risk scores for insurance purposes, while Remote Medical Coders translate medical records into billing codes. Both roles require healthcare certifications and involve remote work, but they serve different functions within the healthcare industry.

What are popular job titles related to Remote Hcc Risk Adjustment jobs in Philadelphia, PA? For Remote Hcc Risk Adjustment jobs in Philadelphia, PA, the most frequently searched job titles are:
What job categories do people searching Remote Hcc Risk Adjustment jobs in Philadelphia, PA look for? The top searched job categories for Remote Hcc Risk Adjustment jobs in Philadelphia, PA are:
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Remote Hcc Risk Adjustment jobs near you

Remote Nurse Practitioner

Purposelink Recruitment

Wilmington, DE • Remote

Full-time

Posted 6 days ago

Job description

Qualifications

Required: 2 Years Triage experience AND leadership experience.
  • Master's degree or higher in Nursing or a related clinical field
  • 2+ years of experience in any of the following:
    • Telemedicine Care
    • Care Management
  • Active clinical licensure — any of the following:
    • Nurse Practitioner (NP) – Delaware (DE)
    • Family Nurse Practitioner (FNP) – Delaware (DE)
  • OR any of the following nationally recognized NP certifications:
    • Family Nurse Practitioner (FNP)
    • Nurse Practitioner (NP)
    • Gerontological Nurse Practitioner (GNP)
Preferred
  • 1+ years of Medicaid or Dual Eligible (D‑SNP) populations
  • Experience working in interdisciplinary care teams
  • Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures
  • Background in home‑based care, transitional care, or chronic disease management
Overview

Join our client's innovative healthcare team to deliver virtual, physician‑led care for medically complex Medicaid and Dual Eligible patients across Delaware. This role offers flexibility, autonomy, and the opportunity to help launch a new market focused on proactive, home‑based care that improves patient outcomes and reduces avoidable hospitalizations.

Key Responsibilities
  • Provide comprehensive care management for medically complex Medicaid and D‑SNP patients through telehealth and remote monitoring
  • Collaborate with physicians, RNs, social workers, therapists, caregivers, PCPs, managed care organizations, and community partners
  • Guide patients and caregivers through care transitions, including hospital‑to‑home coordination and advance care planning
  • Support quality initiatives through accurate clinical documentation, including HCC coding, risk adjustment, and closure of STAR/HEDIS gaps
  • Contribute to the development of care pathways, workflows, and best practices as the Delaware program expands
  • Build strong, trusting relationships with patients, families, caregivers, and interdisciplinary team members
Schedule & Shift Details
  • Participate in a shared 24/7 clinical triage rotation to prevent avoidable emergency department visits and hospitalizations