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Vp Risk Adjustment Medicare Jobs (NOW HIRING)

Urrly

VP, Strategic Accounts - Health Plans

New York, NY · On-site +1

$175K - $215K/yr

Role: SVP, Client Strategy -- Health Plans * Location: Remote, United States * Pay: $175,000-$215 ... Strong understanding of value-based care, Medicare Advantage, risk adjustment, quality, or care-gap ...

Martins Point Health Care

$286K - $353K/yr

Position Summary The Vice President, Medical Director, Health Plan provides senior clinical ... Provide clinical input into product design, Medicare bids, risk adjustment, STARS, HEDIS, value ...

Phsorg

Analyze the impact of risk adjustment models, acuity shifts, redeterminations and eligibility churn ... Ensure Commercial and Medicare rates balance competitiveness and adequacy, and comply with ...

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Vp Risk Adjustment Medicare information

See salary details

$43.5K

$157.5K

$277.5K

How much do vp risk adjustment medicare jobs pay per year?

As of Sep 13, 2026, the average yearly pay for vp risk adjustment medicare in the United States is $157,532.00, according to ZipRecruiter salary data. Most workers in this role earn between $115,000.00 and $190,000.00 per year, depending on experience, location, and employer.

What does a VP Risk Adjustment Medicare do?

A VP of Risk Adjustment Medicare oversees the strategy and execution of risk adjustment programs within Medicare plans to ensure accurate reimbursement from the Centers for Medicare & Medicaid Services (CMS). This role involves managing teams, analyzing data, ensuring compliance with regulations, and implementing best practices to optimize risk scores. They also collaborate with clinical, operational, and IT departments to improve documentation, coding accuracy, and patient outcomes. The VP is responsible for staying up-to-date with CMS guidelines and leading the organization in adapting to policy changes.

How does a VP Risk Adjustment Medicare collaborate with cross-functional teams to ensure accurate risk scoring?

As a VP of Risk Adjustment for Medicare, you will work closely with clinical, data analytics, IT, and compliance teams to ensure that risk adjustment processes are accurate and up-to-date with regulatory requirements. Collaboration often involves leading cross-departmental meetings to review coding accuracy, provider documentation, and data integrity. You will also coordinate with external vendors and internal stakeholders to implement process improvements and address gaps in risk capture, playing a key role in driving organizational performance and compliance.

What are the key skills and qualifications needed to thrive as a VP Risk Adjustment Medicare?

To thrive as a VP Risk Adjustment Medicare, you need deep expertise in healthcare risk adjustment methodologies, regulatory compliance, and a strong background in health plan operations, often supported by an advanced degree in healthcare administration or a related field. Familiarity with data analytics tools, risk adjustment software, and CMS guidelines is typically required, along with relevant certifications such as Certified Risk Adjustment Coder (CRC). Leadership, strategic thinking, and effective communication are vital soft skills for guiding teams and collaborating with executive stakeholders. These skills and qualifications are crucial for optimizing revenue accuracy, ensuring regulatory compliance, and driving organizational success in the complex Medicare landscape.

What is the difference between Vp Risk Adjustment Medicare vs Vp Risk Adjustment Medicaid?

AspectVp Risk Adjustment MedicareVp Risk Adjustment Medicaid
CredentialsTypically requires healthcare administration, actuarial, or related certificationsSimilar credentials, often with additional state-specific Medicaid knowledge
Work EnvironmentPrimarily in healthcare organizations, insurance companies, or government agencies focusing on MedicareSimilar settings but with a focus on Medicaid programs and state agencies
Employer & Industry UsageUsed by Medicare Advantage plans, healthcare providers, and insurersUsed by Medicaid managed care organizations, state agencies, and insurers

Both roles involve managing risk adjustment processes, but Vp Risk Adjustment Medicare focuses on Medicare beneficiaries, while Vp Risk Adjustment Medicaid concentrates on Medicaid populations and state-specific regulations.

What are popular job titles related to Vp Risk Adjustment Medicare jobs?

For Vp Risk Adjustment Medicare jobs, the most frequently searched job titles are:

Infographic showing various Vp Risk Adjustment Medicare job openings in the United States as of September 2026, with employment types broken down into 100% Full Time. Highlights an 65% In-person, 5% Hybrid, and 30% Remote job distribution, with an average salary of $157,532 per year, or $75.7 per hour.

VP, Strategic Accounts - Health Plans

New York, NY • On-site, Remote

Urrly
See more jobs at Urrlyexternal

$175K - $215K/yr

Full-time

Medical, Dental, Vision

Re-posted 15 days ago

Job description

Join a fast-growing healthcare technology company and lead executive relationships with the nation's largest health plans.

Role Snapshot
  • Role: SVP, Client Strategy -- Health Plans
  • Location: Remote, United States
  • Pay: $175,000-$215,000 base + bonus + equity
  • Schedule: Flexible and outcome-driven

Our client helps health plans deliver last-mile value-based care, including in-home risk assessments, annual wellness visits, care-gap closure, and member engagement.

They are seeking a senior executive to elevate client strategy, strengthen executive relationships, and build a scalable account management model for enterprise health-plan clients.

You will inherit a function that needs stronger strategic leadership, more consistent executive engagement, and clearer alignment between client priorities, program performance, and measurable outcomes.

What You'll Do
  • Lead executive relationships across enterprise health-plan accounts
  • Translate client priorities into measurable program and business outcomes
  • Build QBR, EBR, governance, and executive communication frameworks
  • Establish a consultative, enterprise-level account management model
  • Create case studies tied to outcomes, ROI, quality, and client value
  • Improve alignment across health-plan stakeholders and internal teams
  • Coach the team toward more strategic and proactive client engagement
  • Build scalable client playbooks, standards, and operating rhythms
What You'll Bring
  • VP, SVP, EVP, or Head-level client strategy or account leadership experience
  • Experience managing complex enterprise relationships with health plans or healthcare payers
  • Strong understanding of value-based care, Medicare Advantage, risk adjustment, quality, or care-gap closure programs
  • Experience building scalable QBR, EBR, governance, or account management frameworks
  • Proven success managing and influencing executive stakeholders
  • Ability to connect program performance to business outcomes and client value
  • Authorization to work in the United States
Preferred Experience
  • Experience with a payer-services, population health, healthcare technology, or in-home clinical services organization
  • Leadership within a high-growth or rapidly evolving company
  • Turnaround experience within an underperforming client function
  • Experience building enterprise account management playbooks at scale
Compensation and Benefits
  • $175,000-$215,000 base salary
  • Annual performance bonus
  • Equity participation
  • Medical, dental, and vision benefits
  • Direct exposure to executive leadership

This is a builder role with significant influence from day one. You will help transform client relationships from reactive and tactical to consultative, measurable, and strategic.

Apply today to lead enterprise health-plan relationships and build the client strategy function at a fast-growing healthcare technology company.

Employment Type: FULL_TIME

Apply