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Seasonal Risk Adjustment Specialist Jobs (NOW HIRING)

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 ...

The Alliance

Risk Adjustment Director

California, MO · On-site

$200 - $250/hr

... services, and specialist services * Develop, plan, organize, and direct finance programs and ... Medicare risk adjustment processes, a minimum of two years of experience related to Medicare ...

Sentara Health

Risk Adjustment Coder

Virginia Beach, VA · Hybrid

$10K/mo

Risk Adjustment Coding & Documentation Specialist, Talroo-Allied Health, Medical Office Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and ...

Molina Healthcare

Auditor, Risk Adjustment (Remote)

$49K - $107K/yr

... specialist performance.. • Facilitates audits on external Molina vendor performance. Required Qualifications • At least 5 years of coding, medical record chart review, and risk adjustment data ...

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Seasonal Risk Adjustment Specialist information

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$11K

$142.3K

$190K

How much do seasonal risk adjustment specialist jobs pay per year?

As of Aug 11, 2026, the average yearly pay for seasonal risk adjustment specialist in the United States is $142,322.00, according to ZipRecruiter salary data. Most workers in this role earn between $132,500.00 and $132,500.00 per year, depending on experience, location, and employer.

What is the difference between Seasonal Risk Adjustment Specialist vs Actuarial Analyst?

AspectSeasonal Risk Adjustment SpecialistActuarial Analyst
Required CredentialsTypically requires health insurance or risk adjustment certifications, sometimes a related degreeUsually requires actuarial credentials (SOA/ASA) and mathematics/statistics background
Work EnvironmentHealthcare or insurance companies, focusing on risk adjustment processesInsurance firms, consulting, or government agencies analyzing risk and financial models
Employer & Industry UsageCommon in health plans and Medicare/Medicaid sectorsWidely used in insurance, finance, and consulting industries

The Seasonal Risk Adjustment Specialist primarily focuses on health insurance risk adjustment processes, often requiring specific certifications related to healthcare. In contrast, an Actuarial Analyst typically holds actuarial credentials and works on broader risk modeling and financial analysis. Both roles are vital in the insurance industry but differ in scope, credentials, and work environment.

More about Seasonal Risk Adjustment Specialist jobs
What cities are hiring for Seasonal Risk Adjustment Specialist jobs? Cities with the most Seasonal Risk Adjustment Specialist job openings:
What are the most commonly searched types of Risk Adjustment Specialist jobs? The most popular types of Risk Adjustment Specialist jobs are:
What states have the most Seasonal Risk Adjustment Specialist jobs? States with the most job openings for Seasonal Risk Adjustment Specialist jobs include:
What job categories do people searching Seasonal Risk Adjustment Specialist jobs look for? The top searched job categories for Seasonal Risk Adjustment Specialist jobs are:
Seasonal Risk Adjustment Specialist jobs near you
Infographic showing various Seasonal Risk Adjustment Specialist job openings in the United States as of August 2026, with employment types broken down into 94% Full Time, and 6% Part Time. Highlights an 81% In-person, 6% Hybrid, and 13% Remote job distribution, with an average salary of $142,322 per year, or $68.4 per hour.

Risk Adjustment Specialist

MetroPlusHealth

Manhattan, NY • Hybrid

$72K - $82K/yr

Full-time

Posted 5 days ago

MetroPlusHealth rating

6.7

Company rating: 6.7 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

264th of 304 rated insurance

Job description

Position Overview

Risk Adjustment is a growing and critical field within Health Insurance Finance. This is your opportunity

to support this function at MetroPlusHealth, New York City’s not-for-profit health insurance company. 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 information to federal and state agencies. You will work independently to monitor and support internal partners and external vendors in data collection and submission. You’ll apply your problem-solving skills to resolve issues you identify. You will also calculate errors and acceptance rates to track progress over time.

This opportunity is ideal for an individual interested in working at the intersection of Health Insurance Analytics and Operations, who excels at creative problem solving, is detail-oriented, and who is committed to our mission of providing access to health insurance to all New Yorkers.

Scope of Role and Responsabilities 

  • Ongoing monitoring of data submitted by vendors to ensure project goals are being met,
  • submitted data is complete and accurate, and errors are identified quickly.
  • Proactively work with external and internal partners to resolve issues – this includes identifying the root cause, devising plans to remediate, and ensuring on-time completion from all stakeholders.
  • Support end-to-end submission processes and encounter data across all lines of business, including Medicaid, Medicare and Affordable Care Act/QHP. This includes monitoring submission timelines, resubmissions, and validating accepted and rejected encounter metrics to ensure data is accurately reflected in downstream reporting.
  • Perform financial impact analysis of Risk Adjustment activities, including implications of data errors, missed submissions, and remediation efforts.
  • Access and analyze data within the enterprise data warehouse to evaluate member, provider, claims, and enrollment data in support of Risk Adjustment and encounter data initiatives.
  • Utilize dashboards to identify trends and potential opportunities in data collection and reportng. 

Required Education, Training & Professional Experience

  • Bachelor’s degree required, with a demonstrated interest in Finance, Social Services or Health Care.
  • Minimum of 3-4 years’ experience required working for a Health Plan, or in a Finance, Project Management or Actuarial capacity in another industry.
  • Ability to work independently to investigate, pinpoint, and resolve problems.
  • Strong analytical and financial skills. Experience using SQL, R, SAS or another programming language is a plus.
  • Proactive communication style and ability to work with a variety of stakeholders to achieve project goals.

Professional Competencies 

  • Integrity and Trust
  • Customer Focus
  • Functional/Technical skills
  • Written/Oral Communication

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