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Risk Adjustment Jobs (NOW HIRING)

Medix

Risk Adjustment Director

Scotts Valley, CA · On-site

$96.15 - $120.19/hr

Job Summary Our client is seeking a skilled Risk Adjustment Director to serve as the executive strategic leader and subject matter expert for the health plan's Risk Adjustment Department. The primary ...

Mass Advantage

Manager, Risk Adjustment

Worcester, MA · On-site

We are looking for a Manager of Risk Managment to oversee Mass Advantages's full suite of Risk Adjustment activities. This position is responsible for the strategy, execution and performance of ...

MetroPlusHealth

Risk Adjustment Specialist

Manhattan, NY · Hybrid

$72K - $82K/yr

As a Risk Adjustment Specialist, you will support ongoing processes and lead projects to ensure MetroPlusHealth is fully capturing data about our high-risk populations and submitting accurate ...

MetroPlusHealth

Risk Adjustment Specialist

Manhattan, NY · On-site

$72K - $82K/yr

As a Risk Adjustment Specialist, you will support ongoing processes and lead projects to ensure MetroPlusHealth is fully capturing data about our high-risk populations and submitting accurate ...

PacificSource

Senior Risk Adjustment Analyst

Virginia, MN · On-site

$74.60 - $126.82/hr

Senior Risk Adjustment Analyst Senior Risk Adjustment (RA) Analyst assists in accurate and comprehensive data submission to regulatory entities such as the Centers for Medicare & Medicaid Services ...

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on ...

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on ...

Jobtailor

Senior Risk Adjustment Analyst

Virginia, MN · On-site

$110 - $160/hr

Develop and improve processes related to risk adjustment and quality improvement * Validate data integrity and collaborate with technical teams to improve data pipelines * Report on actionable ...

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on ...

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on ...

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Risk Adjustment information

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$74

How much do risk adjustment jobs pay per hour?

As of Sep 1, 2026, the average hourly pay for risk adjustment in the United States is $30.34, according to ZipRecruiter salary data. Most workers in this role earn between $19.47 and $38.70 per hour, depending on experience, location, and employer.

What is risk adjustment?

Risk adjustment is a statistical process used in healthcare to account for the underlying health status and related costs of patients when comparing outcomes or setting payments. It helps ensure that providers or health plans are fairly compensated for caring for sicker patients and prevents them from being penalized for taking on higher-risk individuals. By considering factors such as age, gender, and chronic conditions, risk adjustment creates a more level playing field and promotes quality care across diverse populations.

How does a risk adjustment professional typically collaborate with other departments to ensure accurate data capture and reporting?

Risk Adjustment professionals frequently work cross-functionally with coding specialists, data analysts, and clinicians to ensure that patient diagnoses and health records are accurately documented and coded. This collaboration often involves regular meetings to review medical records, resolve discrepancies, and discuss updates in coding guidelines. By working closely with these teams, Risk Adjustment staff help ensure compliance with industry standards and maximize reimbursement accuracy, all while improving the quality of patient data. Strong communication and teamwork skills are essential in this role to effectively bridge gaps between clinical and administrative functions.

What are the key skills and qualifications needed to thrive as a risk adjustment specialist, and why are they important?

To thrive as a Risk Adjustment Specialist, you need a strong understanding of medical coding (ICD-10), healthcare regulations, and data analysis, often supported by a degree in health information management or a related field. Familiarity with coding software, EHR systems, and certifications such as CRC (Certified Risk Adjustment Coder) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for accurately interpreting medical records and collaborating with providers. These skills and qualifications are essential to ensure accurate risk scoring, regulatory compliance, and proper reimbursement in the healthcare system.

What is the difference between Risk Adjustment vs Coding Specialist?

AspectRisk AdjustmentCoding Specialist
Required CredentialsCertifications like RHIA, RHIT, or CCS; knowledge of risk modelsCertifications such as CPC, CCS; coding accuracy skills
Work EnvironmentHealthcare organizations, insurance companies, risk adjustment teamsHospitals, clinics, medical billing departments
Industry UsageUsed to adjust payments based on patient risk profilesUsed to translate medical records into billing codes
Common Search/ComparisonOften compared for roles in healthcare finance and reimbursementCompared for medical coding and billing roles

Risk Adjustment professionals focus on analyzing patient data to ensure accurate risk scores for reimbursement, while Coding Specialists translate medical records into standardized codes for billing. Both roles require healthcare knowledge but serve different functions within the healthcare revenue cycle.

How long does it take to become a risk adjustment coder?

Becoming a risk adjustment coder typically requires completing a specialized training program or certification, which can take from a few months up to a year. Many professionals also pursue coding certifications such as CPC or CCS to enhance their skills and job prospects, with experience in medical coding and understanding of health records being important for success.
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What are the most commonly searched types of Risk Adjustment jobs?

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Risk Adjustment jobs near you
Infographic showing various Risk Adjustment job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 89% Full Time, 8% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $63,100 per year, or $30.3 per hour.

Risk Adjustment Director

Medix

Scotts Valley, CA • On-site

$96.15 - $120.19/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 7 days ago

Job description

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a skilled Risk Adjustment Director to serve as the executive strategic leader and subject matter expert for the health plan's Risk Adjustment Department. The primary responsibilities include designing and overseeing data strategies to ensure accurate member health coding, managing financial impacts of risk scores, leading a team, and acting on behalf of the CFO when necessary.
Responsibilities / Job Duties
  • Build the roadmap for the health plan's risk adjustment goals to improve data collection, reporting, and auditing.
  • Track risk scores and work closely with Actuaries and Financial Planning & Analysis to align with budgets.
  • Optimize Risk Adjustment Factor improvements through external vendors.
  • Partner with the Provider Relations Director to train and support doctors on compliant, accurate medical record coding.
  • Hire, train, mentor, and evaluate a team of risk adjustment professionals.
  • Formulate and manage the Risk Adjustment Department's operational budget.
  • Oversee Medicare DSNP Risk Adjustment strategy and execution.
  • Directly support key operational initiatives to ensure program stability and scalability.

Minimum Education and Experience Qualification Requirements
Education
  • Bachelor's degree in Finance, Business, Healthcare Administration, Mathematics, Statistics, or a closely related field.

Qualifications
  • 10 years of experience in healthcare finance or analytics.
  • 5 years of experience with Medicare risk adjustment processes.
  • 2 years of experience related to Medicare Managed Care Programs.
  • 3 years of supervisory experience.
  • Expert knowledge of Medicare HCC risk adjustment models.
  • Working knowledge of CPT, HCPCS, and ICD-9/10 medical coding.
  • Familiarity with data analytical tools like SQL and visualization platforms like Tableau.

Skills
  • Technical proficiency in data analytical tools and coding methodologies.
  • Strong leadership and team management skills.
  • Excellent communication and organizational abilities.

Schedule / Shift
Mon-Fri 8am-5pm (potential for some flexibility for early/later start upon discussion)
Benefits
  • Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
  • Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
  • 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
  • Short Term Disability Insurance.
  • Term Life Insurance Plan.

Required Employment / Compliance Language
Medix is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex
* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
* As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients
Medix Staffing Solutions logo

About Medix Staffing Solutions

Sourced by ZipRecruiter

Since 2001, we’ve been dedicated to helping you achieve your goals. Medix was created to become a leading provider of workforce solutions for clients and candidates across the healthcare and life sciences industries. Today, we are that leader. Headquartered in Chicago, we have 23 offices across the United States, and staff talent around the world. Medix is committed to fulfilling our core purpose as an organization: to positively impact the lives of our talent, clients, and teammates through employment, philanthropy, and opportunity. The combination of purpose and values has nurtured our thriving culture that encourages our internal team to excel at work and in everyday life.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Chicago, IL, US

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