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Risk Adjustment Coding Manager Jobs in California

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HCC Coder

Alhambra, CA · On-site

$34 - $39/hr

Attend weekly meetings and present HCC Risk Adjustment Coding Department feedback, including data ... Other duties as assigned by the Billing Manager, Medical Director, Finance Director, or Executive ...

HCC Coder

Alhambra, CA · On-site

$50 - $70/hr

Attend weekly meetings and present HCC Risk Adjustment Coding Department feedback, including data ... Other duties as assigned by the Billing Manager, Medical Director, Finance Director, or Executive ...

New

Coding Manager

Los Angeles, CA · On-site

$120 - $180/hr

The Manager is accountable for coding quality, productivity, inventory, compliance remediation ... Partners with Compliance to maintain a risk-based coding audit program, review internal and ...

... Risk Adjustment Factor. * Conduct internal reviews of documentation and billing on a timely basis. * Identify coding and billing risk areas, conduct focused reviews. Ensure accurate coding by ...

Showing results 41-60

Risk Adjustment Coding Manager information

What is a risk adjustment coding manager?

Risk Adjustment Coding Managers are professionals responsible for overseeing the medical coding process related to risk adjustment in healthcare organizations. They ensure accurate coding of diagnoses and procedures to reflect the health status of patients, which is essential for proper reimbursement from Medicare Advantage and other insurance plans. These managers lead teams of coders, maintain compliance with regulations, and implement quality assurance processes to optimize coding accuracy and organizational performance.

What are the key skills and qualifications needed to thrive as a risk adjustment coding manager?

To thrive as a Risk Adjustment Coding Manager, you need expertise in medical coding (CPT, ICD-10), risk adjustment methodologies, and a background in healthcare management, often supported by a coding certification such as CPC, CRC, or CCS. Familiarity with coding software, EHR systems, and data analytics tools is typically required. Strong leadership, attention to detail, and the ability to communicate compliance standards effectively are crucial soft skills. These skills ensure accurate risk adjustment coding, regulatory compliance, and improved financial outcomes for healthcare organizations.

What are some common challenges faced by risk adjustment coding managers, and how can they effectively address them?

Risk Adjustment Coding Managers often encounter challenges such as ensuring coding accuracy, keeping up with regulatory changes, and coordinating across multidisciplinary teams. To address these, effective managers implement rigorous quality assurance processes, provide ongoing coder education, and maintain open communication with clinical, compliance, and data analytics teams. Staying updated on CMS guidelines and fostering a culture of continuous improvement are also key strategies for success in this role.

What is the difference between Risk Adjustment Coding Manager vs Risk Adjustment Coder?

AspectRisk Adjustment Coding ManagerRisk Adjustment Coder
CertificationsAHIMA or AAPC credentials, management experienceAHIMA or AAPC credentials, coding certification
Work EnvironmentSupervisory role, overseeing coding teamsPerforming coding tasks directly on patient records
Employer & IndustryHealth plans, healthcare providers, insurance companiesHospitals, clinics, health plans

The Risk Adjustment Coding Manager oversees coding teams and ensures compliance, while the Risk Adjustment Coder focuses on accurately coding patient records. Both roles require similar certifications but differ in responsibilities and work environment, with managers handling supervision and coders performing detailed coding tasks.

What are the most commonly searched types of Risk Adjustment Coding jobs in California?

The most popular types of Risk Adjustment Coding jobs in California are:

What are popular job titles related to Risk Adjustment Coding Manager jobs in California?

For Risk Adjustment Coding Manager jobs in California, the most frequently searched job titles are:

What job categories do people searching Risk Adjustment Coding Manager jobs in California look for?

The top searched job categories for Risk Adjustment Coding Manager jobs in California are:

What cities in California are hiring for Risk Adjustment Coding Manager jobs?

Cities in California with the most Risk Adjustment Coding Manager job openings:

Infographic showing various Risk Adjustment Coding Manager job openings in California as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, 2% Temporary, and 1% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution.

Business Development Executive (MedInsight)

Milliman

San Francisco, CA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago


Key responsibilities

  • Develop deep expertise in MedInsight's risk adjustment software and analytics to engage prospects as a credible advisor.

  • Build and execute a strategic national territory plan across health plans, provider organizations, ACOs, MSOs, and risk-bearing entities through targeted research, outbound prospecting, and insight-led engagement.

  • Identify, develop, and rigorously qualify opportunities using a structured sales methodology, mapping decision-makers and influencers across various functions.


Milliman rating

8.5

Company rating: 8.5 out of 10

Based on 7 frontline employees who took The Breakroom Quiz


Job description

Individual(s) must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future.  

Company Overview: 

Leading with our core values of Quality, Integrity, and Opportunity, MedInsight is one of the healthcare industry’s most trusted solutions for healthcare intelligence. Our company purpose is to empower easy, data-driven decision-making on important healthcare questions. Through our products, education, and services, MedInsight is making an impact on healthcare by helping to drive better outcomes for patients while reducing waste. Over 300 leading healthcare organizations have come to rely on MedInsight analytic solutions for healthcare cost and care management. 

MedInsight is a subsidiary of Milliman; a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare financing, enterprise risk management and regulatory compliance, data analytics and business transformation as well as a range of other consulting and technology solutions. 

Position Summary: 

MedInsight is hiring a Business Development Executive to lead new-logo acquisition and expansion revenue across our risk adjustment portfolio. This is a selling specialist role: you will own a national territory selling MedInsight’s risk adjustment software and analytics to health plans, provider organizations, ACOs, MSOs, and other risk-bearing entities.

Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance outcomes. You will sell to the leaders who own those outcomes (risk adjustment, coding, quality, finance, and compliance executives), and you will build credibility by understanding their priorities and engaging in meaningful business conversations rather than leading with product features.

This is a highly consultative, insight-led role that leverages Challenger-style selling principles. Reporting to the SVP of Sales & Growth and working alongside a peer group of BDEs, you will have dedicated support from marketing, sales development, and sales engineering. As MedInsight enters its next phase of growth, this is a high-visibility role with significant upside for career advancement.

 Primary Responsibilities: 

  • Develop deep expertise in MedInsight’s risk adjustment software and analytics, and in the surrounding market (CMS-HCC models, RADV, quality programs, value-based care, and the competitive landscape) to engage prospects as a credible advisor.
  • Build and execute a strategic national territory plan across health plans, provider organizations, ACOs, MSOs, and risk-bearing entities through targeted research, outbound prospecting, and insight-led engagement.
  • Identify, develop, and rigorously qualify opportunities using a structured sales methodology, mapping decision-makers and influencers across executive, clinical, financial, operational, and compliance functions.
  • Drive multi-threaded deal progression with stakeholders including C-suite executives, risk adjustment and coding/CDI leaders, quality and finance leaders, operations, and IT.
  • Lead consultative conversations that surface explicit and unrecognized needs across RAF performance, coding accuracy, documentation integrity, audit readiness, provider engagement, and both retrospective and prospective risk adjustment.
  • Deliver compelling commercial narratives that challenge the status quo and position MedInsight as a strategic solution for improving risk capture, compliance, operational efficiency, and reimbursement outcomes.
  • Partner closely with Marketing on outbound opportunity creation, campaign follow-up, event engagement, and account-based prospecting.
  • Collaborate with Sales Engineering, Product, Client Success, and Subject Matter Experts to deliver tailored demonstrations and ROI-driven business cases tied to measurable outcomes rather than features alone.
  • Consistently achieve and exceed quota and pipeline-generation targets, and maintain accurate forecast, opportunity, account, and activity data in Salesforce to support disciplined territory management.

Preferred Skills and Experience: 

  • 8 or more years of full-cycle new-business development in complex, consultative enterprise sales, preferably in healthcare technology, analytics, SaaS, or payment integrity / risk adjustment solutions.
  • Demonstrated success selling into healthcare payer, provider, and/or risk-bearing organizations, navigating complex buying groups and long sales cycles.
  • Direct experience selling risk adjustment, coding, CDI, quality, value-based care, population health, or related analytics solutions is strongly preferred.
  • Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly preferred.
  • Proven track record of building pipelines from scratch and executing territory plans in greenfield, competitive, or underpenetrated markets.
  • Demonstrated success negotiating and closing complex enterprise agreements with senior decision-makers, including CFOs, CIOs, COOs, CMOs, Chief Population Health Officers, and VP-level risk adjustment and compliance leaders.
  • Skilled at partnering with Sales Engineering and cross-functional teams to deliver outcome-oriented demonstrations and solution positioning.
  • Bachelor’s degree in business, healthcare administration, finance, economics, public health, or a related field preferred; advanced degree (MBA, MHA, MPH, or similar) a plus. Neither is required.

Key Competencies: 

  • Challenger Mindset: Leads with insight, teaches prospects something new about their risk adjustment performance, and creates urgency for change.
  • Consultative Seller: Uncovers root business issues and ties solutions to measurable financial, compliance, and operational outcomes.
  • Analytical & Strategic: Synthesizes market, financial, and operational data into sharp, customer-specific account strategies.
  • Entrepreneurial: Resourceful and proactive; creates momentum, opens doors, and builds pipeline in ambiguous, evolving markets.
  • Emotionally Intelligent: Builds trust quickly, navigates complex stakeholder dynamics, and turns feedback into growth.
  • Intellectually Curious: Stays ahead of shifting regulations, reimbursement models, and emerging market opportunities.
  • Effective Communication: A clear, confident, persuasive communicator in writing and in person, including at the executive level.
  • Organized & Resilient: Manages multiple opportunities and internal partnerships with precision, follow-through, and persistence.

Location

This role can be remote within the U.S. The expected application deadline for this job is August 30, 2026. 

Compensation

The overall salary range for this role is $104,900 - $199,065. For candidates residing in: 

  • Alaska, California, Connecticut, Illinois, Maryland, Massachusetts, New Jersey, New York City, Pennsylvania, Virginia, Washington, or the District of Columbia, the salary range is $120,635 - $199,065.  
  • All other locations the salary range is $104,900 - $173,100. 

A combination of factors will be considered, including, but not limited to, education, relevant work experience, qualifications, skills, certifications, etc. 

What makes this a great opportunity? 

  • Join an innovative, high growth company with a solid industry track record 
  • Bring your expertise and ideas to directly impact and help build the next generation of MedInsight products and solutions 
  • Be recognized for your contributions and impact
  • Work for a company that values your wellbeing and professional growth, offering a flexible work environment, generous benefits package, and investment in the development of your career 

Benefits 

We offer a comprehensive benefits package designed to support employees’ health, financial security, and well-being. Benefits include:

  • Medical, Dental and Vision – Coverage for employees, dependents, and domestic partners
  • Employee Assistance Program (EAP) – Confidential support for personal and work-related challenges
  • 401(k) Plan – Includes a company matching program and profit-sharing contributions.
  • Discretionary Bonus Program – Recognizing employee contributions
  • Flexible Spending Accounts (FSA) – Pre-tax savings for dependent care, transportation, and eligible medical expenses
  • Paid Time Off (PTO) – Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis
  • Holidays – A minimum of 10 paid holidays per year
  • Family Building Benefits – Includes adoption and fertility assistance
  • Paid Parental Leave – 11 weeks of paid leave for employees who meet eligibility criteria. 
  • Life Insurance & AD&D – 100% of premiums covered by Milliman
  • Short-Term and Long-Term Disability – Fully paid by Milliman

Equal Opportunity

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, or status as a protected veteran. 

#LI-REMOTE

#LI-SM1

#MedInsight


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About Milliman

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Milliman delivers market-leading services and solutions to clients worldwide. Today, we are helping companies take on some of the world's most critical and complex issues, including retirement funding and healthcare financing, risk management and regulatory compliance, data analytics and business transformation.

Industry

Business management consulting and fitness and sports centers

Company size

1,001 - 5,000 Employees

Headquarters location

Seattle, WA, US