Health Information Management (RHIA/RHIT) * Nursing - Strong understanding of clinical documentation and medical record review * Certified Risk Adjustment Coder (CRC) with compliance experience
Health Information Management (RHIA/RHIT) * Nursing - Strong understanding of clinical documentation and medical record review * Certified Risk Adjustment Coder (CRC) with compliance experience
Knowledge of Medicaid Risk Adjustment * Working with Medicaid Risk models * Master's degree (e.g., Health Informatics, Data Science, Actuarial, Statistics, or MBA) preferred * Experience working ...
Knowledge of Medicaid Risk Adjustment * Working with Medicaid Risk models * Master's degree (e.g., Health Informatics, Data Science, Actuarial, Statistics, or MBA) preferred * Experience working ...
Experience with HCC/RAF coding, Medicare Risk Adjustment, Clinical Documentation Improvement (CDI), or Population Health preferred. * Experience with electronic medical record systems; Cerner ...
Experience with HCC/RAF coding, Medicare Risk Adjustment, Clinical Documentation Improvement (CDI), or Population Health preferred. * Experience with electronic medical record systems; Cerner ...
Experience with HCC/RAF coding, Medicare Risk Adjustment, Clinical Documentation Improvement (CDI), or Population Health preferred. * Experience with electronic medical record systems; Cerner ...
Experience with HCC/RAF coding, Medicare Risk Adjustment, Clinical Documentation Improvement (CDI), or Population Health preferred. * Experience with electronic medical record systems; Cerner ...
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 ...
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 ...
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Ludlow, MA. This unique opportunity adapts to your ...
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Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Ludlow, MA. This unique opportunity adapts to your ...
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Northampton, MA. This unique opportunity adapts to ...
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Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Northampton, MA. This unique opportunity adapts to ...
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Spencer, MA. This unique opportunity adapts to your ...
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Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Spencer, MA. This unique opportunity adapts to your ...
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Spencer, MA. This unique opportunity adapts to your ...
Quick apply
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Spencer, MA. This unique opportunity adapts to your ...
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Chicopee, Massachusetts. This unique opportunity ...
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Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Chicopee, Massachusetts. This unique opportunity ...
Description Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Spencer, MA. This unique opportunity ...
Description Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Spencer, MA. This unique opportunity ...
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Holyoke, MA. This unique opportunity adapts to your ...
Quick apply
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Holyoke, MA. This unique opportunity adapts to your ...
Description Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Holyoke, MA. This unique opportunity ...
Description Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Holyoke, MA. This unique opportunity ...
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Northampton, MA. This unique opportunity adapts to ...
Quick apply
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Northampton, MA. This unique opportunity adapts to ...
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Westfield, MA. This unique opportunity adapts to your ...
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Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Westfield, MA. This unique opportunity adapts to your ...
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Ludlow, MA. This unique opportunity adapts to your ...
Quick apply
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Ludlow, MA. This unique opportunity adapts to your ...
Nurse Practitioner (NP) - Full-Time - In-Home Health Risk Assessments (HRA) - $7,500 Sign-On Bonus
Holyoke, MA · On-site
We are hiring Full-Time Nurse Practitioners to complete Comprehensive Health Assessments (CHA) and Health Risk Assessments (HRA) for Medicare and Medicaid members in their homes and residential ...
Quick apply
Nurse Practitioner (NP) - Full-Time - In-Home Health Risk Assessments (HRA) - $7,500 Sign-On Bonus
Holyoke, MA · On-site
We are hiring Full-Time Nurse Practitioners to complete Comprehensive Health Assessments (CHA) and Health Risk Assessments (HRA) for Medicare and Medicaid members in their homes and residential ...
Nurse Practitioner (NP) - Full-Time - In-Home Health Risk Assessments (HRA) - $7,500 Sign-On Bonus
Holyoke, MA · On-site
We are hiring Full-Time Nurse Practitioners to complete Comprehensive Health Assessments (CHA) and Health Risk Assessments (HRA) for Medicare and Medicaid members in their homes and residential ...
Quick apply
Nurse Practitioner (NP) - Full-Time - In-Home Health Risk Assessments (HRA) - $7,500 Sign-On Bonus
Holyoke, MA · On-site
We are hiring Full-Time Nurse Practitioners to complete Comprehensive Health Assessments (CHA) and Health Risk Assessments (HRA) for Medicare and Medicaid members in their homes and residential ...
Clinical Risk Manager
Hartford, CT · On-site
The Risk Manager works collaboratively with clinical leadership, legal counsel, and the Risk ... Strong understanding of hospital and patient care operations, Public Health Code regulations, Joint ...
Clinical Risk Manager
Hartford, CT · On-site
The Risk Manager works collaboratively with clinical leadership, legal counsel, and the Risk ... Strong understanding of hospital and patient care operations, Public Health Code regulations, Joint ...
Clinical Risk Manager
Hartford, CT · On-site
The Risk Manager works collaboratively with clinical leadership, legal counsel, and the Risk ... Strong understanding of hospital and patient care operations, Public Health Code regulations, Joint ...
Clinical Risk Manager
Hartford, CT · On-site
The Risk Manager works collaboratively with clinical leadership, legal counsel, and the Risk ... Strong understanding of hospital and patient care operations, Public Health Code regulations, Joint ...
Seasonal Optum Health Coding Risk Adjustment information
See Springfield, MA salary details
$21.83 is the 25th percentile. Wages below this are outliers.
$17.01 - $21.89
25% of jobs
The median wage is $25.16 / hr.
$21.89 - $26.76
37% of jobs
$29.25 is the 75th percentile. Wages above this are outliers.
$26.76 - $31.64
25% of jobs
$31.64 - $36.52
4% of jobs
$36.52 - $41.40
4% of jobs
$41.40 - $46.28
2% of jobs
$46.28 - $51.15
2% of jobs
$51.15 - $56.03
0% of jobs
$56.03 - $60.91
0% of jobs
$60.91 - $65.79
0% of jobs
$65.79 - $70.67
0% of jobs
$17
$29
$70
How much do seasonal optum health coding risk adjustment jobs pay per hour?
As of Jul 27, 2026, the average hourly pay for seasonal optum health coding risk adjustment in Springfield, MA is $29.19, according to ZipRecruiter salary data. Most workers in this role earn between $21.78 and $28.99 per hour, depending on experience, location, and employer.
What are some common challenges faced by Seasonal Optum Health Coding Risk Adjustment professionals, and how can they be managed?
Seasonal Optum Health Coding Risk Adjustment professionals often encounter challenges such as handling high volumes of medical records within tight deadlines and ensuring coding accuracy to meet regulatory standards. Staying up-to-date with frequent coding guideline changes and adapting quickly to new technologies or platforms are also common hurdles. To manage these challenges, it's helpful to establish efficient workflows, participate in ongoing training, and maintain open communication with team members and supervisors for clarification or support.
What is the difference between Seasonal Optum Health Coding Risk Adjustment vs Medical Coder?
| Aspect | Seasonal Optum Health Coding Risk Adjustment | Medical Coder |
|---|---|---|
| Certifications | CPHQ, CPC, or CCS often preferred | CPC, CCS, or equivalent certifications |
| Work Environment | Healthcare insurance, risk adjustment teams, remote or office-based | Hospitals, clinics, or insurance companies, often office-based |
| Job Focus | Analyzing and coding health data for risk adjustment, seasonal workload peaks | Assigning medical codes to patient records for billing and documentation |
Seasonal Optum Health Coding Risk Adjustment specialists focus on analyzing health data for risk adjustment, often during peak seasons, requiring specific certifications. Medical Coders primarily assign codes to medical records for billing, working in various healthcare settings. While both roles involve medical coding, their focus, environment, and seasonal demands differ significantly.
What are the key skills and qualifications needed to thrive as a Seasonal Optum Health Coding Risk Adjustment Specialist, and why are they important?
To excel as a Seasonal Optum Health Coding Risk Adjustment Specialist, you need expertise in medical coding (preferably with a CPC, CRC, or CCS certification), a solid understanding of ICD-10 guidelines, and knowledge of risk adjustment methodologies. Familiarity with electronic health record (EHR) systems, coding software, and Optum's proprietary platforms is typically required. Attention to detail, analytical thinking, and effective communication are essential soft skills for accurately interpreting clinical documentation and collaborating with healthcare teams. These competencies are crucial to ensure precise coding, regulatory compliance, and optimal reimbursement for healthcare organizations.
What is a Seasonal Optum Health Coding Risk Adjustment position?
A Seasonal Optum Health Coding Risk Adjustment position involves reviewing medical records and coding diagnoses for risk adjustment purposes, typically during peak times of the year. These professionals help ensure that patient health conditions are accurately documented and coded according to regulatory guidelines. This role supports healthcare organizations in receiving proper reimbursement and maintaining compliance. Seasonal positions are usually temporary, aligning with periods of increased workload, such as annual data submissions.
What job categories do people searching Seasonal Optum Health Coding Risk Adjustment jobs in Springfield, MA look for? The top searched job categories for Seasonal Optum Health Coding Risk Adjustment jobs in Springfield, MA are:
$75K - $165K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 5 days ago
CVS Health rating
5.8
Based on 4,317 frontline employees who took The Breakroom Quiz
88th of 109 rated pharmacies
Job description
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position Summary
As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.
The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.
Key Responsibilities
Lead the Medicare Advantage Risk Adjustment compliance program.
Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.
Assess operational processes for compliance risks related to risk adjustment activities.
Develop and implement corrective action plans for identified compliance issues.
Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.
Required Qualifications
Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance
Minimum 5 years in a leadership role
One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)
Willingness to travel up to 10% (including by plane)
Preferred Qualifications
Health Information Management (RHIA/RHIT)
Nursing - Strong understanding of clinical documentation and medical record review
Certified Risk Adjustment Coder (CRC) with compliance experience
Provider coding audit/compliance leadership experience
Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits
Education
Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.
Pay Range
The typical pay range for this role is:
$75,400.00 - $165,954.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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About CVS Health
Sourced by ZipRecruiter
Industry
Health care and social assistance and retail
Company size
10,000+ Employees
Headquarters location
Woonsocket, RI, US