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Senior Risk Adjustment Auditor Jobs in Wisconsin

As the Sr. Security/Risk Analyst, you will architect and execute your technical expertise ... Log Analysis, Incident Response/Reporting, Auditing * Proven background in network and operating ...

Senior Internal Auditor

Milwaukee, WI · On-site

$83K - $103K/yr

As a Senior Internal Auditor based in Milwaukee, WI, you will join a dynamic, global Internal Audit ... In parallel, you will support the execution of risk-focused operational audits by contributing to ...

Senior Internal Auditor

Milwaukee, WI · On-site

$83K - $103K/yr

Participate in the audit risk assessment process, identifying opportunities to apply AI, analytics, and experimentation to strengthen assurance practices. * Identify, implement, and drive adoption of ...

Senior Internal Auditor

Milwaukee, WI · Hybrid

$83K - $103K/yr

Participate in the audit risk assessment process, identifying opportunities to apply AI, analytics, and experimentation to strengthen assurance practices. * Identify, implement, and drive adoption of ...

WI · On-site

$200 - $300/hr

Strong understanding of HEDIS, STAR ratings, risk adjustment, and preventative care measures. * Demonstrated ability to manage chronic conditions and promote population health in a senior patient ...

IT Auditor Senior I

Milwaukee, WI · Hybrid

$92K - $121K/yr

The IT Auditor Senior is an experienced auditor proficient in the day-to-day tasks of executing an ... to business and risk. * Communicate the impact of identified observations to not only the ...

IT Auditor Senior I

Milwaukee, WI · Hybrid

$92K - $121K/yr

The IT Auditor Senior is an experienced auditor proficient in the day-to-day tasks of executing an ... to business and risk. * Communicate the impact of identified observations to not only the ...

In parallel, you will support the execution of risk-focused operational audits by contributing to ... senior audit staff, adapting to change, escalating questions or risks as appropriate, and ...

In parallel, you will support the execution of risk-focused operational audits by contributing to ... senior audit staff, adapting to change, escalating questions or risks as appropriate, and ...

Fundamental understanding of IIA standards, auditing concepts, internal controls, and risk ... senior audit staff, adapting to change, escalating questions or risks as appropriate, and ...

Fundamental understanding of IIA standards, auditing concepts, internal controls, and risk ... senior audit staff, adapting to change, escalating questions or risks as appropriate, and ...

Fundamental understanding of IIA standards, auditing concepts, internal controls, and risk ... senior audit staff, adapting to change, escalating questions or risks as appropriate, and ...

Showing results 21-40

Senior Risk Adjustment Auditor information

What is a senior risk adjustment auditor?

Senior Risk Adjustment Auditors are experienced professionals who review medical records and data to ensure accurate coding and documentation for risk adjustment purposes, primarily in healthcare settings. They help organizations comply with government regulations and maximize appropriate reimbursement by identifying and correcting coding errors or gaps. Their role involves analyzing patient data, collaborating with coding teams, and providing feedback or training to improve documentation practices. Senior auditors often have advanced knowledge of ICD-10-CM coding, risk adjustment models (such as HCC), and auditing standards. Their expertise helps healthcare organizations maintain compliance and optimize financial performance.

How does a senior risk adjustment auditor typically collaborate with coding teams and healthcare providers to ensure accurate documentation and coding?

A Senior Risk Adjustment Auditor often works closely with medical coding teams and healthcare providers to review patient records for accuracy and compliance with risk adjustment guidelines. This collaboration may involve providing feedback on documentation quality, clarifying coding ambiguities, and offering training or guidance on best practices. Regular meetings and audits help ensure that everyone is aligned with current regulations and organizational standards. Effective communication and teamwork are essential to maintain high-quality, compliant coding that supports proper reimbursement and patient care.

What are the key skills and qualifications needed to thrive as a senior risk adjustment auditor?

To thrive as a Senior Risk Adjustment Auditor, you need deep expertise in medical coding (ICD-10-CM), risk adjustment methodologies, and a background in healthcare compliance, typically supported by certifications such as CRC, CPC, or CCS-P. Familiarity with auditing platforms, data analysis tools, and electronic medical records systems is crucial. Exceptional attention to detail, analytical thinking, and strong communication skills help auditors identify discrepancies and effectively collaborate with providers. These competencies ensure accurate risk scoring, regulatory compliance, and optimal reimbursement for healthcare organizations.

What is the difference between Senior Risk Adjustment Auditor vs Risk Adjustment Auditor?

AspectSenior Risk Adjustment AuditorRisk Adjustment Auditor
CertificationsCPMA, RAC, or similarCPMA, RAC, or similar
Work EnvironmentHealthcare organizations, insurance companies, consulting firmsHealthcare providers, insurance companies, auditing firms
Job ResponsibilitiesLeading audits, mentoring, complex data analysisPerforming audits, data review, compliance checks

Both roles require similar certifications and work in healthcare or insurance settings. The Senior Risk Adjustment Auditor typically handles more complex audits, provides mentorship, and takes on leadership tasks, whereas the Risk Adjustment Auditor focuses on executing audits and data analysis. The senior role involves greater responsibility and expertise, often leading to career advancement in risk adjustment auditing.

What are popular job titles related to Senior Risk Adjustment Auditor jobs in Wisconsin? For Senior Risk Adjustment Auditor jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Senior Risk Adjustment Auditor jobs in Wisconsin look for? The top searched job categories for Senior Risk Adjustment Auditor jobs in Wisconsin are:
What cities in Wisconsin are hiring for Senior Risk Adjustment Auditor jobs? Cities in Wisconsin with the most Senior Risk Adjustment Auditor job openings:
Infographic showing various Senior Risk Adjustment Auditor job openings in Wisconsin as of August 2026, with employment types broken down into 100% Full Time. Highlights an 69% In-person, 8% Hybrid, and 23% Remote job distribution.

Actuarial Manager (FSA) - Medicare / Provider VBP (CMH Health)

Milliman

Brookfield, WI • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

New


Milliman rating

8.0

Company rating: 8.0 out of 10

Based on 6 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.

Milliman's CMH Health Practice is seeking a credentialed Actuarial Manager with strong Medicare experience who will serve in a client-facing role, manage junior staff, and help us capitalize on major growth opportunities in provider value-based payment (VBP) consulting. This role sits within our rapidly growing Provider VBP Enablement vertical, advising health systems, physician groups, and Accountable Care Organizations (ACOs) on Medicare shared savings, risk adjustment, total cost of care benchmarking, and related financial strategy. Actuarial Managers work in a wide variety of areas within the healthcare industry while working alongside some of the leading experts in the field.

Who We Are

Milliman is one of the leading experts in healthcare financing and delivery. We advise clients on a wide range of issues—from assessing the impact of healthcare reform on organizations or populations to streamlining operations while advancing the quality of patient care. Our consulting work is supported by a powerful toolkit of data analytics solutions and informed by the most trusted, comprehensive set of cost guidelines in the industry.

Job Responsibilities

  • Serve as credible client-facing actuary on complex Medicare advisory work, including provider VBP, ACO strategy, and Medicare Advantage engagements
  • Advise health systems, physician groups, and ACOs on Medicare Shared Savings Program (MSSP) performance, total cost of care (TCOC) benchmarking, and risk adjustment
  • Support emerging ACO program opportunities, including the CMS LEAD (Leveraging Efficiency And Driving-quality) model and other CMMI innovation programs
  • Manage and direct professional and senior professional staff on client engagements
  • Lead workstreams independently, freeing senior team members to focus on business development and strategic oversight
  • Provide quality review and mentoring to junior staff
  • Perform data analysis using Excel, SAS, Python, SQL, and proprietary Milliman programs to assist with consulting for various health insurance work areas (Medicare, Commercial / ACA, Medicaid, Long Term Care, Pharmacy, Provider, and more)
  • Support financial modeling for ACO performance evaluation, risk adjustment strategy, and shared savings projections
  • Responsible for reviewing the work of others and assisting with research and product development
  • Responsible for training and coaching professional staff
  • Responsible for several projects simultaneously, providing insight into the technical direction of each project, verifying the initial reasonableness of the solution, and creating client communications for review by Consultants

Minimum requirements

  • Bachelor's or Master's degree in a quantitative field (Bachelor's degree is required)
  • 7+ years of full-time actuarial experience, primarily working with Medicare programs (Medicare experience is required – either Medicare Advantage (MA) or Accountable Care Organization (ACO) work)
  • FSA designation with the Society of Actuaries (SOA)
  • Strong analytical and communication skills with the ability to interact directly with clients
  • Demonstrated ability to manage and mentor junior staff
  • Thorough understanding of Microsoft Excel and actuarial concepts

Competencies and Behaviors that Support Success in this Role

  • Openness and enthusiasm for using AI and large language model (LLM) tools to enhance productivity and consulting workflows
  • Intellectual curiosity and a motivation to learn new domains, methods, and technologies
  • Experience working with Python, SQL, SAS, VBA, or other coding/data analytics languages
  • Experience mentoring staff and managing projects
  • Strong communication skills (both verbal and written)
  • Ability to help identify client issues and resources needed to solve problems
  • Analytical thinking skills to evaluate analyses for communication to clients
  • Ability to help plan and organize work for projects
  • Identify project deliverables, meet deadlines, and ensure compliance with quality procedures
  • Strong time management skills
  • Ability to work independently and within a team
  • Client focused and results oriented
  • Organizational expertise and flexibility
  • Ambition and excitement for professional development within the actuarial field

The Team 

Within a project team, consultants, managers, and analysts coordinate their efforts to deliver client reports and deliverables. Consultants are responsible for building relationships with clients, directing projects, and presenting results. Project managers work directly with analysts by reviewing work, answering questions, and developing client correspondence. Analysts are responsible for the majority of the technical work, which may include analyzing data, completing actuarial calculations, developing and utilizing actuarial models, and implementing software solutions.

Location

It is preferred that candidates work on-site at our Chicago, IL, Milwaukee, WI, or Hartford, CT office. Remote candidates will be considered. The expected application deadline for this job is August 19, 2026.

Compensation

The overall range for this role is $103,500 - $214,820. For candidates residing in:

  • Alaska, California, Connecticut, Illinois, Maryland, Massachusetts, New Jersey, New York City, Pennsylvania, Virginia, Washington, or the District of Columbia the range is $119,025 - $214,820.
  • All other locations the range is $103,500 - $186,800

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

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 observed holidays per year.
  • Family Building Benefits – Includes adoption and fertility assistance.
  • Paid Parental Leave – Up to 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.


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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

Company size

1,001 - 5,000 Employees

Headquarters location

Seattle, WA, US

Year founded

1947