ZipRecruiter

Log In

1

Vice President Hcc Risk Adjustment Coder Jobs in Illinois

PDP Group, Inc.

VP - General Liability

Chicago, IL

Continuously review portfolio for exposures and pricing adjustments. Develop recommendations for ... risk appetite of the BGSU. Participate in, debate and discuss accounts at Peer Review meetings ...

Zero Hash

VP of Engineering, Trade

Chicago, IL · On-site +1

$185K - $239K/yr

Partner with Compliance, Risk, and Legal to ensure trading systems meet the regulatory requirements ... Stay technically credible, engage deeply enough in system design and code-level decisions to earn ...

University of Utah

Associate Vice President

Campus, IL · On-site

$170K - $187K/yr

Details Open Date 07/15/2026 Requisition Number PRN45659B Job Title Associate Vice President Working Title Asc Vice President for Student Engagement Career Progression Track EXE Track Level FLSA Code ...

University of Utah

Associate Vice President

Campus, IL · On-site

$170K - $187K/yr

Details Open Date 07/15/2026 Requisition Number PRN45659B Job Title Associate Vice President Working Title Asc Vice President for Student Engagement Career Progression Track EXE Track Level FLSA Code ...

next page

Showing results 1-20

All JobsVice President Hcc Risk Adjustment Coder JobsVice President Hcc Risk Adjustment Coder Jobs in Illinois

Vice President Hcc Risk Adjustment Coder information

What is a Vice President HCC Risk Adjustment Coder?

A Vice President HCC (Hierarchical Condition Category) Risk Adjustment Coder is a senior executive responsible for overseeing the medical coding operations related to risk adjustment in healthcare organizations. They lead teams that ensure accurate coding of patient diagnoses and health information, which impacts how healthcare providers are reimbursed by insurance payers, especially Medicare Advantage plans. Their role typically involves compliance oversight, quality assurance, training coders, and strategic planning to optimize risk scores. These professionals require extensive experience in medical coding, deep knowledge of HCC models, and strong leadership skills. They play a critical part in helping organizations maximize compliant reimbursement and improve patient outcomes.

What are the key skills and qualifications needed to thrive as a Vice President HCC Risk Adjustment Coder?

To thrive as a Vice President HCC Risk Adjustment Coder, you need deep expertise in HCC coding, risk adjustment methodologies, healthcare regulations, and a relevant certification such as CPC, CRC, or CCS. Mastery of coding software, EHR systems, and data analytics platforms is typically required. Leadership, strategic thinking, attention to detail, and strong communication skills distinguish top performers in this role. These skills are crucial for ensuring coding accuracy, regulatory compliance, and driving organizational success in value-based care environments.

What are some common challenges faced by a Vice President HCC Risk Adjustment Coder, and how can they be managed?

A Vice President HCC Risk Adjustment Coder often faces the challenge of ensuring coding accuracy and compliance across large teams while keeping up with evolving CMS guidelines. Managing remote or distributed coding staff, integrating new technology solutions, and balancing productivity with quality assurance are also common hurdles. Success in this role requires strong communication skills, ongoing coder education, and the implementation of robust audit processes to maintain data integrity and regulatory compliance.

What is the difference between Vice President Hcc Risk Adjustment Coder vs Hcc Risk Adjustment Coder?

AspectVice President Hcc Risk Adjustment CoderHcc Risk Adjustment Coder
CredentialsAdvanced certifications, leadership experienceCertifications like CPC, CCS, or RHIT
Work EnvironmentExecutive-level, strategic planningOperational, coding departments
Industry UsageUsed in large healthcare organizations, insurersCommon in hospitals, clinics, coding firms

The Vice President Hcc Risk Adjustment Coder focuses on strategic leadership and oversight of risk adjustment coding programs, often requiring advanced certifications and leadership skills. In contrast, the Hcc Risk Adjustment Coder handles day-to-day coding tasks, ensuring accurate HCC coding based on medical records. Both roles are vital in healthcare risk management but differ mainly in scope, responsibilities, and experience level.

What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Illinois?

The most popular types of Hcc Risk Adjustment Coder jobs in Illinois are:

What are popular job titles related to Vice President Hcc Risk Adjustment Coder jobs in Illinois?

For Vice President Hcc Risk Adjustment Coder jobs in Illinois, the most frequently searched job titles are:

What job categories do people searching Vice President Hcc Risk Adjustment Coder jobs in Illinois look for?

The top searched job categories for Vice President Hcc Risk Adjustment Coder jobs in Illinois are:

What cities in Illinois are hiring for Vice President Hcc Risk Adjustment Coder jobs?

Cities in Illinois with the most Vice President Hcc Risk Adjustment Coder job openings:

Vice President Hcc Risk Adjustment Coder jobs near you

Senior Manager, Corporate Compliance - Risk Adjustment

CVS Health

Northbrook, IL

$75K - $165K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 4 hours ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,339 frontline employees who took The Breakroom Quiz

91st of 113 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.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/12/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

What CVS Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply