Bachelor's degree or equivalent combination of education and experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 2+ years of program and/or project management experience in risk adjustment ...
Bachelor's degree or equivalent combination of education and experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 2+ years of program and/or project management experience in risk adjustment ...
Risk & Quality Performance Manager (Remote)
Long Beach, CA · On-site +1
$66K - $129K/yr
... risk adjustment and/or quality • 2+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems • 2+ years of data analysis experience utilizing ...
Risk & Quality Performance Manager (Remote)
Long Beach, CA · On-site +1
$66K - $129K/yr
... risk adjustment and/or quality • 2+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems • 2+ years of data analysis experience utilizing ...
Risk & Quality Performance Manager (Remote)
Long Beach, CA · Remote
$66K - $129K/yr
Bachelor's degree or equivalent combination of education and experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 2+ years of program and/or project management experience in risk adjustment ...
Risk & Quality Performance Manager (Remote)
Long Beach, CA · Remote
$66K - $129K/yr
Bachelor's degree or equivalent combination of education and experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 2+ years of program and/or project management experience in risk adjustment ...
Specialist, Provider Engagement (Remote in FL)
Long Beach, CA · Remote
$40K - $46K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Focuses on smaller, less advanced Tier 2 and Tier 3 providers, ensuring they have engagement plans to ...
Specialist, Provider Engagement (Remote in FL)
Long Beach, CA · Remote
$40K - $46K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Focuses on smaller, less advanced Tier 2 and Tier 3 providers, ensuring they have engagement plans to ...
Telehealth Nurse Practitioner
Los Angeles, CA · Remote
$600 - $720/day
Document HCC (risk adjustment) during visits * Close HEDIS (quality measures) care gaps * Review ... Code with ICD-10 and CPT II * Deliver care plans and follow-up * Keep clean, audit-ready ...
Telehealth Nurse Practitioner
Los Angeles, CA · Remote
$600 - $720/day
Document HCC (risk adjustment) during visits * Close HEDIS (quality measures) care gaps * Review ... Code with ICD-10 and CPT II * Deliver care plans and follow-up * Keep clean, audit-ready ...
Specialist, Provider Engagement (Remote in FL)
Long Beach, CA · On-site +1
$45K - $88K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Focuses on smaller, less advanced Tier 2 and Tier 3 providers, ensuring they have engagement plans to ...
Specialist, Provider Engagement (Remote in FL)
Long Beach, CA · On-site +1
$45K - $88K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Focuses on smaller, less advanced Tier 2 and Tier 3 providers, ensuring they have engagement plans to ...
Specialist, Provider Engagement (Remote in FL)
Long Beach, CA · Remote
$40K - $46K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Focuses on smaller, less advanced Tier 2 and Tier 3 providers, ensuring they have engagement plans to ...
Specialist, Provider Engagement (Remote in FL)
Long Beach, CA · Remote
$40K - $46K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Focuses on smaller, less advanced Tier 2 and Tier 3 providers, ensuring they have engagement plans to ...
Senior Specialist, Health Plan Provider Engagement (Remote in NM)
Long Beach, CA · Remote
$40K - $48K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Senior Specialist, Health Plan Provider Engagement (Remote in NM)
Long Beach, CA · Remote
$40K - $48K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Senior Specialist, Health Plan Provider Engagement (Remote in NM)
Long Beach, CA · Remote
$40K - $48K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Senior Specialist, Health Plan Provider Engagement (Remote in NM)
Long Beach, CA · Remote
$40K - $48K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Specialist, Health Plan Provider Engagement (Remote)
Long Beach, CA · On-site +1
$45K - $88K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less advanced tier II and tier III providers have engagement plans to meet annual ...
Specialist, Health Plan Provider Engagement (Remote)
Long Beach, CA · On-site +1
$45K - $88K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less advanced tier II and tier III providers have engagement plans to meet annual ...
Senior Specialist, Health Plan Provider Engagement (Remote in NM)
Long Beach, CA · On-site +1
$54K - $107K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Senior Specialist, Health Plan Provider Engagement (Remote in NM)
Long Beach, CA · On-site +1
$54K - $107K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Manager, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · Remote
$65K - $115K/yr
Sets and manages performance goals, ensuring providers meet quality and risk adjustment targets through coaching and consistent engagement. Tracks and measures the effectiveness of engagement ...
Manager, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · Remote
$65K - $115K/yr
Sets and manages performance goals, ensuring providers meet quality and risk adjustment targets through coaching and consistent engagement. Tracks and measures the effectiveness of engagement ...
Manager, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · Remote
$65K - $120K/yr
Sets and manages performance goals, ensuring providers meet quality and risk adjustment targets through coaching and consistent engagement. Tracks and measures the effectiveness of engagement ...
Manager, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · Remote
$65K - $120K/yr
Sets and manages performance goals, ensuring providers meet quality and risk adjustment targets through coaching and consistent engagement. Tracks and measures the effectiveness of engagement ...
Sets and manages performance goals, ensuring providers meet quality and risk adjustment targets through coaching and consistent engagement. Tracks and measures the effectiveness of engagement ...
Sets and manages performance goals, ensuring providers meet quality and risk adjustment targets through coaching and consistent engagement. Tracks and measures the effectiveness of engagement ...
Manager, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · On-site +1
$65K - $142K/yr
Sets and manages performance goals, ensuring providers meet quality and risk adjustment targets through coaching and consistent engagement. Tracks and measures the effectiveness of engagement ...
Manager, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · On-site +1
$65K - $142K/yr
Sets and manages performance goals, ensuring providers meet quality and risk adjustment targets through coaching and consistent engagement. Tracks and measures the effectiveness of engagement ...
Specialist, Health Plan Provider Engagement (Remote)
Long Beach, CA · Remote
$45K - $80K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less advanced tier II and tier III providers have engagement plans to meet annual ...
Specialist, Health Plan Provider Engagement (Remote)
Long Beach, CA · Remote
$45K - $80K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less advanced tier II and tier III providers have engagement plans to meet annual ...
Senior Specialist, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · Remote
$40K - $46K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Senior Specialist, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · Remote
$40K - $46K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Senior Specialist, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · On-site +1
$49K - $107K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Senior Specialist, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · On-site +1
$49K - $107K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Senior Specialist, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · Remote
$40K - $46K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Senior Specialist, Health Plan Provider Engagement (Remote in MS)
Long Beach, CA · Remote
$40K - $46K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and ...
Specialist, Health Plan Provider Engagement (Remote)
Long Beach, CA · Remote
$40K - $46K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less advanced tier II and tier III providers have engagement plans to meet annual ...
Specialist, Health Plan Provider Engagement (Remote)
Long Beach, CA · Remote
$40K - $46K/yr
Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less advanced tier II and tier III providers have engagement plans to meet annual ...
Remote Risk Adjustment Coder information
See California salary details
$18.09 is the 25th percentile. Wages below this are outliers.
$15.66 - $18.14
26% of jobs
$18.14 - $20.62
9% of jobs
$20.62 - $23.10
12% of jobs
The median wage is $24.34 / hr.
$23.10 - $25.58
9% of jobs
$25.58 - $28.06
11% of jobs
$28.06 - $30.54
5% of jobs
$32.40 is the 75th percentile. Wages above this are outliers.
$30.54 - $33.02
6% of jobs
$33.02 - $35.50
5% of jobs
$35.50 - $37.98
5% of jobs
$37.98 - $40.46
3% of jobs
$40.46 - $42.94
10% of jobs
$15
$27
$42
How much do remote risk adjustment coder jobs pay per hour?
What are the key skills and qualifications needed to thrive as a Remote Risk Adjustment Coder, and why are they important?
What is a Remote Risk Adjustment Coder?
What is the difference between Remote Risk Adjustment Coder vs Remote Medical Coder?
| Aspect | Remote Risk Adjustment Coder | Remote Medical Coder |
|---|---|---|
| Certifications | AHIMA or AAPC Risk Adjustment certifications | AAPC CPC, CCS, or RHIT certifications |
| Work Environment | Healthcare insurance, payer organizations, risk adjustment teams | Hospitals, clinics, physician offices, insurance companies |
| Industry Usage | Primarily in health insurance and risk adjustment programs | Broad healthcare settings including hospitals and outpatient clinics |
Remote Risk Adjustment Coders focus on analyzing patient data for insurance risk models, requiring specific risk adjustment certifications. Remote Medical Coders handle a wider range of medical records coding across various healthcare settings. While both roles involve medical coding, their industries, certifications, and primary tasks differ significantly.
What are the common challenges faced by Remote Risk Adjustment Coders and how can they be managed?
What Does a Remote Risk Adjustment Coder Do?
As a remote risk adjustment coder, your duties and responsibilities involve performing medical coding and reviewing medical codes for adherence to risk adjustment models. Employers may also expect you to audit medical record data to ensure accuracy. In this role, you work from home to apply codes and make assessments according to regulations and your employer’s operational policies. You also report the results of an audit to the relevant supervisor or coding service provider. It’s your job to ensure compliance with rules related to patient privacy and electronic medical record keeping.

Full-time
Re-posted 28 days ago
Molina Healthcare rating
8.1
Based on 193 frontline employees who took The Breakroom Quiz
133rd of 281 rated insurance
Job description
Job Description
Job Summary
The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage resources and execute performance improvement initiatives in alignment with RQS's strategic objectives.
Job Duties
Collaborate with Health Plan Risk and Quality leaders to improve outcomes by managing Risk/Quality data collection strategy, analytics, and reporting, including but not limited to: Risk/Quality rate trending and forecasting; provider Risk/Quality measure performance, CAHPS and survey analytics, health equity and SDOH, and engaging external vendors.
Monitor projects from inception through successful delivery.
Oversee Risk/Quality data ingestion activities and strategies to optimize completeness and accuracy of EHR/HIE and supplemental data.
Meet customer expectations and requirements, establish, and maintain effective relationships and gain their trust and respect.
Draw actionable conclusions, and make decisions as needed while collaborating with other teams.
Ensure compliance with all regulatory audit guidelines by adhering to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success.
Partner with other teams to ensure data quality through sequential transformations and identify opportunities to close quality and risk care gaps.
Proactively communicate risks and issues to stakeholders and leadership.
Create, review, and approve program documentation, including plans, reports, and records.
Ensure documentation is updated and accessible to relevant parties.
Proactively communicate regular status reports to stakeholders, highlighting progress, risks, and issues.
Job Qualifications
REQUIRED EDUCATION:
Bachelor's degree or equivalent combination of education and experience
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
2+ years of program and/or project management experience in risk adjustment and/or quality
2+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems
2+ years of data analysis experience utilizing technical skillsets and resources to answer nuanced Risk and Quality questions posed from internal and external partners
Familiarity with running queries in Microsoft Azure or SQL server
Healthcare experience and functional risk adjustment and/or quality knowledge
Mastery of Microsoft Office Suite including Excel and Project
Experience partnering with various levels of leadership across complex organizations
Strong quantitative aptitude and problem solving skills
Intellectual agility and ability to simplify and clearly communicate complex concepts
Excellent verbal, written and presentation capabilities
Energetic and collaborative
PREFERRED EDUCATION:
Graduate degree or equivalent combination of education and experience
PREFERRED EXPERIENCE:
Knowledge of, and familiarity with, NCQA, CMS, and State regulatory submission requirements
Experience working in a cross-functional, highly matrixed organization
SQL proficiency
Knowledge of healthcare claim elements: CPT, CPTII, LOINC, SNOMED, HCPS, NDC, CVX, NPIs, TINs, etc.
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:
PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification, and/or comparable coursework desired
#PJCorp
#LI-AC1
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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About Molina Healthcare
Sourced by ZipRecruiter
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Long Beach, CA, US
Year founded
1980