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United Healthcare Risk Adjustment Jobs (NOW HIRING)

Imedica

Risk Adjustment Healthcare Analyst

Minnetonka, MN · On-site

$90K - $155K/yr

The Risk Adjustment Healthcare Analyst (P3) is a senior-level individual contributor responsible ... All candidates must be legally authorized to work in the United States at the time of application.

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United Healthcare Risk Adjustment information

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How much do united healthcare risk adjustment jobs pay per hour?

As of Jun 13, 2026, the average hourly pay for united healthcare risk adjustment in the United States is $38.68, according to ZipRecruiter salary data. Most workers in this role earn between $23.80 and $54.33 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in a United Healthcare Risk Adjustment role, and why are they important?

To thrive in a United Healthcare Risk Adjustment role, you need a strong understanding of healthcare coding (ICD-10), risk adjustment methodologies, and medical record review, often supported by certifications like CRC or CPC. Familiarity with risk adjustment software, claims processing systems, and EHR platforms is typically required. Strong analytical thinking, attention to detail, and effective communication skills help ensure accurate assessments and collaboration with providers. These skills are crucial for optimizing risk scores, ensuring regulatory compliance, and supporting organizational financial performance.

What is the difference between United Healthcare Risk Adjustment vs Medical Coder?

AspectUnited Healthcare Risk AdjustmentMedical Coder
Primary RoleAnalyzes and documents patient health data for risk scoring and reimbursementTranslates medical reports into standardized codes for billing and records
Required CertificationsRisk adjustment training, coding certifications (e.g., CPC)Medical coding certifications (e.g., CPC, CCS)
Work EnvironmentInsurance companies, healthcare providers, remote or office-basedHospitals, clinics, insurance companies, remote or office-based
Industry UsageHealth insurance, risk management, healthcare analyticsMedical billing, healthcare documentation, coding departments

While both roles involve healthcare data, United Healthcare Risk Adjustment specialists focus on analyzing patient data for risk scoring and reimbursement, requiring specialized risk adjustment knowledge. Medical Coders primarily translate clinical documentation into codes for billing. Understanding these differences helps clarify career paths and employer expectations in the healthcare industry.

What is United Healthcare Risk Adjustment?

United Healthcare Risk Adjustment is a program designed to ensure that health plans are adequately compensated for providing coverage to individuals with varying levels of health risk. The process involves collecting and analyzing data about members’ health conditions and demographic information to determine expected healthcare costs. This helps United Healthcare allocate resources appropriately and ensures compliance with government regulations such as those from Medicare Advantage and the Affordable Care Act. Accurate risk adjustment is essential for maintaining fair and sustainable health insurance markets.

How does a United Healthcare Risk Adjustment professional typically collaborate with clinical and data analytics teams to ensure accurate documentation and reporting?

In a United Healthcare Risk Adjustment role, professionals work closely with both clinical staff and data analytics teams to ensure that patient health conditions are accurately documented and coded. This collaboration often involves reviewing medical records, providing feedback to providers on documentation best practices, and working with analysts to identify coding gaps or trends. Regular meetings and cross-functional projects are common, as accurate risk adjustment impacts reimbursement and compliance. Effective communication and teamwork are essential for addressing challenges and maintaining high data quality.
Infographic showing various United Healthcare Risk Adjustment job openings in the United States as of June 2026, with employment types broken down into 97% Full Time, 1% Part Time, 1% Temporary, and 1% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $80,460 per year, or $38.7 per hour.

Sr. Manager, Risk Adjustment & Quality

Centrum Health

Doral, FL • On-site

Full-time

Posted yesterday

Job description

WHO WE ARE
NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.
NeueHealth delivers clinical care to health consumers through our owned clinics - Centrum Health and Premier Medical - as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.
Centrum Health's Sr. Manager of Risk Adjustment and Quality will be responsible for managing a team of Risk Adjustment Coders, HEDIS specialists, Billers, and Auditors to maintain daily billing and coding operations for our wholly owned clinics and affiliated practices. In this role, the candidate must excel at cross-departmental collaboration with Physicians, Clinical Operations, Data/Technology, and Finance teams.
The individual must be a subject matter expert in ACA, Medicare Advantage, Medicaid risk adjustment, billing, and quality operations. The position delivers best-in-class results while operating under strict regulatory adherence and a strong compliance mindset.
This is an onsite position in Doral, FL.
ROLE RESPONSIBILITIES
• The core function of this role includes management of risk adjustment, medical records, coding, and billing operations.
• Lead a team to drive risk adjustment performance across Medicare Advantage, ACO, Medicaid, and ACA lines of business.
• Provide thought leadership in the continued development of the Risk Adjustment and Quality function, including collaboration with analytics and internal technology teams to develop a Risk Adjustment and Quality Suspecting Engine.
• Work closely with internal technical teams to develop in house tools to support Risk Adjustment operations.
• Provide leadership and overall program management for retrospective and prospective encounter facilitation, supplemental data submission, virtual visits, and in-office assessments.
• Collaborate with Actuarial and Analytics teams to design and implement suspecting and segmentation strategies for prospective and retrospective programs.
• Develop short-term, quick-win initiatives as well as long-term, analytics-driven gap-closure programs and tools.
• Communicate complex concepts to non-technical business stakeholders across the full business cycle-from question identification through results interpretation-including data integrity considerations.
• Ensure Centrum Health's ability to meet federal and state regulatory compliance and reporting requirements, including RADV audits, on an annual basis.
• Perform other duties and responsibilities as assigned.
• This position will have direct and indirect supervisory responsibility for risk adjustment program execution and analytics functions.
• Occasional travel may be required.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
  • Bachelor's degree in a healthcare-related field or equivalent experience, required.
  • Six (6) or more years of experience in healthcare Risk Adjustment required.
  • Experience working with primary care providers and practices in value-based care.
  • Three (3) or more years of leadership experience managing and mentoring teams.
  • CPC, CRC, and CPMA certifications are highly preferred.
  • Experience working with Medicare Advantage, ACA, and Medicaid health plans is preferred.
  • Working knowledge of business intelligence tools and their application in driving business decisions.
  • Experience with in-home and virtual engagement capabilities, preferred.
  • Bilingual in Spanish and English required.

PROFESSIONAL COMPETENCIES
• Ability to lead and mentor a highly skilled team.
• Ability to frame and execute end-to-end analyses in collaboration with business and technical stakeholders.
• Expertise in advanced data analysis to identify opportunities and design programs to capture value.
• Experience managing third-party service providers, including TPAs and medical record/chart retrieval functions.
• Eager learner; collaborative partner; clear communicator; and detail-oriented analyst.
• Strong passion for empirical research and data-driven decision-making.
• Experience maintaining payer file integrations and developing performance dashboards using data from multiple reporting sources.
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of NeueHealth, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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