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Remote Medicare Risk Adjustment Jobs in Delaware

Nurse Practitioner

Lewes, DE · Remote

$134K - $135K/yr

This is a remote position. We're Hiring: Nurse Practitioner Delaware | Remote | Full-Time The Role ... risk adjustment, and closure of STAR and HEDIS quality gaps * Help develop and refine care pathways ...

Property Compliance Analyst

Dover, DE · On-site +1

$52K - $70K/yr

Some positions at Novogradac may be open to remote or hybrid work arrangements depending on ... adjustments as needed. * Ability to work collaboratively in a team-oriented environment and ...

Remote Medicare Risk Adjustment information

What is the difference between Remote Medicare Risk Adjustment vs Remote Medical Coding Specialist?

AspectRemote Medicare Risk AdjustmentRemote Medical Coding Specialist
CertificationsCPR, CPC, or RAC certifications often preferredCPC, CCS, or CCS-P certifications
Work EnvironmentHealthcare insurance companies, Medicare plansHospitals, clinics, insurance companies
Industry UsagePrimarily in Medicare risk adjustment programsMedical billing and coding across various healthcare settings

Remote Medicare Risk Adjustment and Remote Medical Coding Specialist roles share certifications and healthcare industry usage but differ in focus. Medicare Risk Adjustment involves analyzing patient data to optimize Medicare plan reimbursements, while Medical Coding Specialists translate medical records into billing codes. Both roles require healthcare knowledge but serve distinct functions within the healthcare revenue cycle.

What are popular job titles related to Remote Medicare Risk Adjustment jobs in Delaware? For Remote Medicare Risk Adjustment jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Remote Medicare Risk Adjustment jobs in Delaware look for? The top searched job categories for Remote Medicare Risk Adjustment jobs in Delaware are:
What cities in Delaware are hiring for Remote Medicare Risk Adjustment jobs? Cities in Delaware with the most Remote Medicare Risk Adjustment job openings:
Infographic showing various Remote Medicare Risk Adjustment job openings in Delaware as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Remote Nurse Practitioner

Purposelink Recruitment

Wilmington, DE • Remote

Full-time

Posted 5 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 licensureany 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