Conduct compliance risk assessments related to coding, documentation, and encounter data ... Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits ...
Conduct compliance risk assessments related to coding, documentation, and encounter data ... Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits ...
... care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly preferred ... VP-level risk adjustment and compliance leaders. * Skilled at partnering with Sales Engineering and ...
... care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly preferred ... VP-level risk adjustment and compliance leaders. * Skilled at partnering with Sales Engineering and ...
Medical Director, Population Health
Chicago, IL · On-site
$170 - $185/hr
... HCC), Stars/HEDIS performance, and chronic condition management. Experience with integrated ... care (risk adjustment, quality, admission prevention) in collaboration with the VP, Provider ...
Medical Director, Population Health
Chicago, IL · On-site
$170 - $185/hr
... HCC), Stars/HEDIS performance, and chronic condition management. Experience with integrated ... care (risk adjustment, quality, admission prevention) in collaboration with the VP, Provider ...
... care (risk adjustment, quality, admission prevention) in collaboration with the VP, Provider ... Define and track key KPIs within your scope (e.g., HCC documentation, Stars/HEDIS measures, care ...
Quick apply
... care (risk adjustment, quality, admission prevention) in collaboration with the VP, Provider ... Define and track key KPIs within your scope (e.g., HCC documentation, Stars/HEDIS measures, care ...
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 ...
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 ...
Vice President of Finance & Administration
Crystal Lake, IL · On-site
$150 - $230/hr
This position oversees accounting, budgeting, forecasting, treasury, risk management, human ... adjustments to drive productivity, employee engagement, retention, profitability, and operational ...
Vice President of Finance & Administration
Crystal Lake, IL · On-site
$150 - $230/hr
This position oversees accounting, budgeting, forecasting, treasury, risk management, human ... adjustments to drive productivity, employee engagement, retention, profitability, and operational ...
This position oversees accounting, budgeting, forecasting, treasury, risk management, human ... adjustments to drive productivity, employee engagement, retention, profitability, and operational ...
Quick apply
This position oversees accounting, budgeting, forecasting, treasury, risk management, human ... adjustments to drive productivity, employee engagement, retention, profitability, and operational ...
Vice President or Senior Vice President, Portfolio Management (Industry Focus: Financial Institut...
Additionally the VP, Portfolio Management will be responsible for ongoing credit monitoring and risk rating for a portfolio of corporate clients with a complexity profile commensurate to experience ...
Vice President or Senior Vice President, Portfolio Management (Industry Focus: Financial Institut...
Additionally the VP, Portfolio Management will be responsible for ongoing credit monitoring and risk rating for a portfolio of corporate clients with a complexity profile commensurate to experience ...
Vice President of Quality and Patient Safety
Lincolnwood, IL · On-site
$160K - $190K/yr
Responsible for understanding and adhering to the organization's Code of Conduct and for ensuring ... Patient Safety & Risk Management: Oversee patient safety programs, conduct root cause analyses, and ...
Vice President of Quality and Patient Safety
Lincolnwood, IL · On-site
$160K - $190K/yr
Responsible for understanding and adhering to the organization's Code of Conduct and for ensuring ... Patient Safety & Risk Management: Oversee patient safety programs, conduct root cause analyses, and ...
Vice President of Quality and Patient Safety
$160K - $190K/yr
Responsible for understanding and adhering to the organization's Code of Conduct and for ensuring ... Patient Safety & Risk Management: Oversee patient safety programs, conduct root cause analyses, and ...
New
Quick apply
Vice President of Quality and Patient Safety
$160K - $190K/yr
Responsible for understanding and adhering to the organization's Code of Conduct and for ensuring ... Patient Safety & Risk Management: Oversee patient safety programs, conduct root cause analyses, and ...
New
Vice President, Enterprise Security
Elk Grove Village, IL · On-site
$154K - $193K/yr
Executive security, threat assessment and travel risk management will also fall under the leadership of the Vice President, Enterprise Security. The successful candidate will feel confident ...
New
Vice President, Enterprise Security
Elk Grove Village, IL · On-site
$154K - $193K/yr
Executive security, threat assessment and travel risk management will also fall under the leadership of the Vice President, Enterprise Security. The successful candidate will feel confident ...
New
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 ...
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 ...
This position oversees accounting, budgeting, forecasting, treasury, risk management, human ... adjustments to drive productivity, employee engagement, retention, profitability, and operational ...
This position oversees accounting, budgeting, forecasting, treasury, risk management, human ... adjustments to drive productivity, employee engagement, retention, profitability, and operational ...
Vice President of Operations
$80K - $95K/yr
Serves as the Risk Manager for the organization and implements a risk management patient safety ... Adhere to CHP's Code of Conduct. * Practice AIDET compliance * Actively participate in weekly ...
Quick apply
Vice President of Operations
$80K - $95K/yr
Serves as the Risk Manager for the organization and implements a risk management patient safety ... Adhere to CHP's Code of Conduct. * Practice AIDET compliance * Actively participate in weekly ...
This position oversees accounting, budgeting, forecasting, treasury, risk management, human ... adjustments to drive productivity, employee engagement, retention, profitability, and operational ...
This position oversees accounting, budgeting, forecasting, treasury, risk management, human ... adjustments to drive productivity, employee engagement, retention, profitability, and operational ...
VP Brokerage Services, @properties
Chicago, IL · On-site
$150K - $180K/yr
Partner with the EVP in executing retention strategies, identifying at-risk agents early, and taking action to maintain long-term loyalty. * Promote and participate in company culture initiatives ...
VP Brokerage Services, @properties
Chicago, IL · On-site
$150K - $180K/yr
Partner with the EVP in executing retention strategies, identifying at-risk agents early, and taking action to maintain long-term loyalty. * Promote and participate in company culture initiatives ...
Risk Management Officer
Rosemont, IL · On-site
Provide independent model risk management and support for the VP of Model Risk as follows: Model ... Evaluate the model adjustments, such as overlays and buffers, wherever applicable. Ongoing Process ...
Risk Management Officer
Rosemont, IL · On-site
Provide independent model risk management and support for the VP of Model Risk as follows: Model ... Evaluate the model adjustments, such as overlays and buffers, wherever applicable. Ongoing Process ...
Vice President Lending
Romeoville, IL · On-site
$125K - $135K/yr
Serve as the primary credit risk officer, evaluating complex credit applications and issuing ... Our dress code is relaxed, business casual and company logo wear * We have a team of trainers to ...
Vice President Lending
Romeoville, IL · On-site
$125K - $135K/yr
Serve as the primary credit risk officer, evaluating complex credit applications and issuing ... Our dress code is relaxed, business casual and company logo wear * We have a team of trainers to ...
VP Brokerage Services, @properties
$150K - $180K/yr
Partner with the EVP in executing retention strategies, identifying at-risk agents early, and taking action to maintain long-term loyalty. * Promote and participate in company culture initiatives ...
VP Brokerage Services, @properties
$150K - $180K/yr
Partner with the EVP in executing retention strategies, identifying at-risk agents early, and taking action to maintain long-term loyalty. * Promote and participate in company culture initiatives ...
Vice President Lending
$125K - $135K/yr
Serve as the primary credit risk officer, evaluating complex credit applications and issuing ... Our dress code is relaxed, business casual and company logo wear * We have a team of trainers to ...
Vice President Lending
$125K - $135K/yr
Serve as the primary credit risk officer, evaluating complex credit applications and issuing ... Our dress code is relaxed, business casual and company logo wear * We have a team of trainers to ...
Vice President Hcc Risk Adjustment Coder information
See Chicago, IL salary details
$88.1K - $104.8K
5% of jobs
$104.8K - $121.5K
5% of jobs
$121.5K - $138.2K
13% of jobs
$140.7K is the 25th percentile. Wages below this are outliers.
$138.2K - $154.9K
13% of jobs
$154.9K - $171.7K
8% of jobs
The median wage is $179.3K / yr.
$171.7K - $188.4K
13% of jobs
$188.4K - $205.1K
14% of jobs
$210.6K is the 75th percentile. Wages above this are outliers.
$205.1K - $221.8K
14% of jobs
$221.8K - $238.5K
6% of jobs
$238.5K - $255.2K
6% of jobs
$255.2K - $272K
3% of jobs
$88.1K
$182K
$272K
How much do vice president hcc risk adjustment coder jobs pay per year?
What is the difference between Vice President Hcc Risk Adjustment Coder vs Hcc Risk Adjustment Coder?
| Aspect | Vice President Hcc Risk Adjustment Coder | Hcc Risk Adjustment Coder |
|---|---|---|
| Credentials | Advanced certifications, leadership experience | Certifications like CPC, CCS, or RHIT |
| Work Environment | Executive-level, strategic planning | Operational, coding departments |
| Industry Usage | Used in large healthcare organizations, insurers | Common 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.
How long does it take to become a vice president hcc risk adjustment coder?
What are some common challenges faced by a Vice President HCC Risk Adjustment Coder, and how can they be managed?
What is a Vice President HCC Risk Adjustment Coder?
What are the key skills and qualifications needed to thrive as a Vice President HCC Risk Adjustment Coder?
$75K - $165K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 12 days ago
CVS Health rating
5.8
Based on 4,328 frontline employees who took The Breakroom Quiz
88th of 110 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
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Industry
Health care and social assistance and retail
Company size
10,000+ Employees
Headquarters location
Woonsocket, RI, US