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Remote Medicare Risk Adjustment Jobs in Ohio (NOW HIRING)

Purposelink Recruitment

Remote Nurse Practitioner

OH · Remote

Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures * Background ... and remote monitoring * Collaborate with physicians, RNs, social workers, therapists, caregivers ...

CareSource

Medical Economics Analyst II

Dayton, OH · On-site +1

$72K - $115K/yr

... risk adjustment dynamics, revenue impacts, utilization management, and identifying key drivers ... Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is required

GenoaBank

Treasury Management Officer

Genoa, OH · Remote

... risk and compliance discipline. Provides customer service to clients/prospects to ensure a thorough ... Coordinates product setup and client training for services such as ACH/wires, remote deposit ...

Relevante, Inc.

Financial Consultant

Cleveland, OH · On-site +1

$112K/yr

Discuss client investment goals with consideration given to risk tolerance, asset allocation ... Work with the advisory team to implement investment plans and coordinate adjustments * Monitor ...

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All JobsMedicare Risk Adjustment JobsRemote Medicare Risk Adjustment JobsRemote Medicare Risk Adjustment Jobs in Ohio

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 the most commonly searched types of Medicare Risk Adjustment jobs in Ohio?

The most popular types of Medicare Risk Adjustment jobs in Ohio are:

What are popular job titles related to Remote Medicare Risk Adjustment jobs in Ohio?

For Remote Medicare Risk Adjustment jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Remote Medicare Risk Adjustment jobs in Ohio look for?

The top searched job categories for Remote Medicare Risk Adjustment jobs in Ohio are:

What cities in Ohio are hiring for Remote Medicare Risk Adjustment jobs?

Cities in Ohio with the most Remote Medicare Risk Adjustment job openings:

Remote Medicare Risk Adjustment jobs near you

Remote Nurse Practitioner

Purposelink Recruitment

OH • Remote

Full-time

Posted 21 days ago

Job description

Qualifications

Required
  • Master's degree or higher in Nursing or a related clinical field
  • 2+ years of experience in any of the following:
    • Telemedicine Care
    • Minimum 2 years of telephone triage experience
    • Care Management
  • Active clinical licensure — any of the following:
    • Nurse Practitioner (NP) – Ohio
    • Family Nurse Practitioner (FNP) – Ohio
  • OR any of the following nationally recognized NP certifications:
    • Family Nurse Practitioner (FNP)
    • Nurse Practitioner (NP)
    • Gerontological Nurse Practitioner (GNP)
Preferred
  • 1+ years of Managed Care experience, especially with 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 Salary 135k

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