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Vice President Hcc Risk Adjustment Coder Jobs in Philadelphia, PA

Ennoble Care

Sr. Medical Economics Analyst

Marlton, NJ · Remote

$120K - $140K/yr

Collaborate with revenue cycle and coding teams to optimize documentation and billing accuracy ... Thorough understanding of and hands-on experience with Medicare risk adjustment and CMS-HCC models

ModernControls LLC

VP of Sales

New Castle, DE · On-site

... oriented Vice President of Sales to driving topline growth, margin expansion, and client ... Ensure deals meet internal risk, margin, and contract requirements prior to acceptance. Support ...

Barclays

Portfolio Risk Oversight VP

Wilmington, DE · On-site

Definition and setting of portfolio, segment and customer risk appetite, policy and limits. Overseeing first line execution within these parameters. Vice President Expectations * To contribute or set ...

MODERNCONTROLS LLC.

VP of Sales

New Castle, DE · On-site

Description ModernControls is seeking a highly motivated, team-oriented Vice President of Sales to ... Ensure deals meet internal risk, margin, and contract requirements prior to acceptance. Support ...

MODERNCONTROLS LLC.

VP of Sales

New Castle, DE · On-site

ModernControls is seeking a highly motivated, team-oriented Vice President of Sales to driving ... Ensure deals meet internal risk, margin, and contract requirements prior to acceptance. Support ...

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All JobsVice President Hcc Risk Adjustment Coder JobsVice President Hcc Risk Adjustment Coder Jobs in Philadelphia, PA

Vice President Hcc Risk Adjustment Coder information

See Philadelphia, PA salary details

$86.3K

$178.3K

$266.4K

How much do vice president hcc risk adjustment coder jobs pay per year?

As of Sep 1, 2026, the average yearly pay for vice president hcc risk adjustment coder in Philadelphia, PA is $178,281.00, according to ZipRecruiter salary data. Most workers in this role earn between $138,200.00 and $206,900.00 per year, depending on experience, location, and employer.

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 popular job titles related to Vice President Hcc Risk Adjustment Coder jobs in Philadelphia, PA?

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

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

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Cities near Philadelphia, PA with the most Vice President Hcc Risk Adjustment Coder job openings:

Vice President Hcc Risk Adjustment Coder jobs near you
Infographic showing various Vice President Hcc Risk Adjustment Coder job openings in Philadelphia, PA as of August 2026, with employment types broken down into 92% Full Time, and 8% Contract. Highlights an 60% In-person, and 40% Remote job distribution, with an average salary of $178,281 per year, or $85.7 per hour.

Sr. Medical Economics Analyst

Ennoble Care

Marlton, NJ • Remote

$120K - $140K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

Ennoble Care rating

4.2

Company rating: 4.2 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

Job description

About Us

Ennoble Care is a mobile primary care, palliative care, and hospice service provider with patients in New York, New Jersey, Maryland, DC, Virginia, Oklahoma, Kansas, Pennsylvania, Texas, Florida, and Georgia. Ennoble Care's clinicians go to the home of the patient, providing continuum of care for those with chronic conditions and limited mobility. Ennoble Care offers a variety of programs including, remote patient monitoring, behavioral health management, and chronic care management, to ensure that our patients receive the highest quality of care by a team they know and trust. We seek individuals who are driven to make a difference and embody our motto, "To Care is an Honor." Join Ennoble Care today!

Position Overview 

We are seeking an experienced Sr. Medical Economics Analyst to join our value-based care (VBC) team in our Accountable Care Organization (ACO). This role requires a seasoned professional with 3-5 years of data analytics experience who can navigate the complex landscape of Medicare risk models, value-based care arrangements, and population health analytics. The ideal candidate will play a critical role in optimizing our organization's performance under CMS total cost of care models while ensuring sustainable financial outcomes. 

Key Responsibilities 

Risk Assessment & Medicare Analytics 

  • Develop and maintain sophisticated risk-adjusted provider group performance models using CMS-HCC methodology.
  • Analyze VBC performance under various CMS and CMMI total cost-of-care models.
  • Monitor and forecast financial performance across assigned patient populations.
  • Conduct comprehensive claims analysis using CCLF (Claims and Claims Line Feed) and BCDA (Beneficiary Claims Data API) datasets, including simulating CMS-HCC risk adjustment. 

Data Management & Analytics 

  • Process and analyze large healthcare datasets, combining multiple data sources including EHR systems and Medicare claims data.
  • Ensure data quality and integrity across all analytical processes. 

Business Intelligence & Reporting 

  • Create fit-for-purpose analytical reports that translate complex actuarial findings into actionable business insights.
  • Develop executive dashboards and performance metrics aligned with organizational strategic goals.
  • Present findings and recommendations to leadership teams and clinical stakeholders.
  • Support budget planning and financial forecasting processes. 

Regulatory Compliance & Process Improvement 

  • Stay current with evolving CMS and CMMI program requirements and quality measures.
  • Collaborate with revenue cycle and coding teams to optimize documentation and billing accuracy. 
Required Qualifications 

Education & Certification 

  • Bachelor's degree in Data Science, Statistics, Mathematics, Economics, Business Administration or related quantitative field 

Experience Requirements 

  • 3-5 years of data analytics experience, preferably in healthcare or Medicare-focused environments
  • Thorough understanding of and hands-on experience with Medicare risk adjustment and CMS-HCC models
  • Demonstrated experience working with CMS and CMMI total cost of care (ACO) programs
  • Proven track record analyzing Medicare claims data, specifically CCLF and BCDA datasets
  • In-depth knowledge of healthcare billing processes from both provider and CMS perspectives 

Technical Proficiency 

  • Advanced proficiency in Microsoft Excel (pivot tables, complex formulas, VBA preferred)
  • Strong SQL skills with ability to write complex queries and optimize database performance
  • Experience with Microsoft Azure cloud platform and related analytics tools
  • Proven ability to work with very large datasets (multi-million row files) and combine data from multiple sources
  • Experience integrating EHR data with claims datasets for comprehensive population health analysis 

Core Competencies 

  • Exceptional analytical and problem-solving capabilities
  • Strong business acumen with the ability to translate technical findings into strategic recommendations
  • Excellent written and verbal communication skills for both technical and non-technical audiences
  • Proven team player with a collaborative approach to cross-functional projects
  • Demonstrated capability to understand and respond to evolving business needs 

Location:  Fully Remote (with up to 10% travel) 

Salary Range: $120,000- $140,000

This position requires the ability to work with sensitive healthcare information and maintain strict confidentiality in accordance with HIPAA and other applicable regulations. 

Full-time employees qualify for the following benefits:

  • Medical, Dental, Vision and supplementary benefits such as Life Insurance, Short Term and Long Term Disability, Flexible Spending Accounts for Medical and Dependent Care, Accident, Critical Illness, and Hospital Indemnity. 
  • Paid Time Off
  • Paid Office Holidays 

All employees qualify for these benefits:

  • Paid Sick Time
  • 401(k) with up to 3% company match
  • Referral Program
  • Payactiv: pay-on-demand. Cash out earned money when and where you need it!

Candidates must disclose any current or future need for employment-based immigration sponsorship (including, but not limited to, OPT, STEM OPT, or visa sponsorship) before an offer of employment is extended.

Ennoble Care is an Equal Opportunity Employer, committed to hiring the best team possible, and does not discriminate against protected characteristics including but not limited to - race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status. 

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