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Work From Home Medicare Risk Adjustment Jobs (NOW HIRING)

Humana

Risk Adjustment Lead - Platform Product Owner

You will connect Medicare Risk Adjustment business leaders, analytics resources, and IT delivery ... Six Sigma certification. Work at Home Requirements: To ensure Home or Hybrid Home/Office employees ...

New

Humana

Risk Adjustment Lead - Platform Product Owner

You will connect Medicare Risk Adjustment business leaders, analytics resources, and IT delivery ... Six Sigma certification. Work at Home Requirements: To ensure Home or Hybrid Home/Office employees ...

New

Greater Good Health

Risk Adjustment Coding Specialist

$80K - $95K/yr

... your work can make a lasting impact. The Role We are looking for a Risk Adjustment Coding ... The ideal candidate brings deep expertise in Medicare risk adjustment, a strong understanding of ...

Humana

Medical Coding Educator

$28 - $31.75/hr

Medicare Risk Adjustment knowledge * CRC -Certified Risk Adjustment Coder * Experience working with healthcare providers * Microsoft Office applications Additional Information Work at home - with ...

Humana

Medical Coding Educator

$28 - $31.75/hr

Medicare Risk Adjustment knowledge * CRC -Certified Risk Adjustment Coder * Experience working with healthcare providers * Microsoft Office applications Additional Information Work at home - with ...

Centene

Risk Adjustment Auditor Educator

$56K - $101K/yr

Work in conjunction with other departments to include Provider Relations, Quality as well as the ... Medicare risk adjustment (HCC Coding) Required Other experience in teaching, training or an ...

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

While your daily work will be completed from your home office, occasional travel may be required ... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ...

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82K - $108K/yr

While your daily work will be completed from your home office, occasional travel may be required ... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ...

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82K - $108K/yr

While your daily work will be completed from your home office, occasional travel may be required ... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ...

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82K - $108K/yr

While your daily work will be completed from your home office, occasional travel may be required ... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ...

Urrly

Telehealth Nurse Practitioner

Des Moines, IA · On-site +1

$600 - $720/day

Join a fast-growing virtual care team and work from home in Iowa while earning $600-$720 per day ... Familiar with HEDIS and risk adjustment workflows * Medicare and Medicaid provider enrollment ...

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Work From Home Medicare Risk Adjustment information

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$22

$40

How much do work from home medicare risk adjustment jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for work from home medicare risk adjustment in the United States is $22.42, according to ZipRecruiter salary data. Most workers in this role earn between $16.11 and $27.16 per hour, depending on experience, location, and employer.

What is a work from home Medicare risk adjustment job?

Work From Home Medicare Risk Adjustment jobs involve evaluating and documenting patient health records to ensure accurate risk scoring for Medicare Advantage plans. Professionals in these roles typically review medical charts, identify diagnoses, and ensure documentation meets regulatory requirements, all from a remote setting. These positions help healthcare organizations receive proper reimbursement from Medicare by accurately reflecting the health status of enrollees. Strong attention to detail, knowledge of ICD-10 coding, and experience with healthcare regulations are usually required.

What are the key skills and qualifications needed to thrive as a work from home Medicare risk adjustment specialist?

To excel as a Work From Home Medicare Risk Adjustment Specialist, you need a deep understanding of ICD-10 coding, risk adjustment methodologies, and relevant healthcare regulations, often supported by a coding certification such as CPC, CRC, or CCS. Familiarity with electronic health record (EHR) systems, coding software, and secure remote communication platforms is crucial. Strong attention to detail, self-motivation, and effective written communication help you accurately review and document patient data while working independently. These skills ensure accurate risk score calculations, regulatory compliance, and effective collaboration with healthcare teams from a remote setting.

What are some common challenges faced when working from home in a Medicare risk adjustment role, and how can they be addressed?

One of the main challenges in a work-from-home Medicare Risk Adjustment role is maintaining effective communication with team members and providers, as much of the collaboration is virtual. Staying updated on frequently changing CMS guidelines and documentation requirements can also be demanding. To address these challenges, it's important to establish regular check-ins with your team, utilize secure digital platforms for information sharing, and dedicate time each week to review new regulations. Staying organized and building strong virtual relationships with colleagues can help ensure accuracy and efficiency in risk adjustment processes.

What is the difference between Work From Home Medicare Risk Adjustment vs Work From Home Medicare Coding Specialist?

AspectWork From Home Medicare Risk AdjustmentWork From Home Medicare Coding Specialist
Required CredentialsCertifications in risk adjustment, healthcare complianceMedical coding certifications (CPC, CCS)
Work EnvironmentRemote, collaborative with healthcare teamsRemote, focused on coding documentation
Employer & Industry UsageHealth plans, Medicare Advantage organizationsHospitals, billing companies, healthcare providers
Common Search & ComparisonYesNo

Work From Home Medicare Risk Adjustment involves analyzing patient data to predict healthcare costs and ensure accurate reimbursements, requiring risk adjustment certifications. In contrast, Work From Home Medicare Coding Specialists focus on reviewing medical records and assigning appropriate codes, primarily needing coding certifications. Both roles are remote and essential in the healthcare industry but serve different functions within Medicare services.

More about Work From Home Medicare Risk Adjustment jobs

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Cities with the most Work From Home Medicare Risk Adjustment job openings:

What states have the most Work From Home Medicare Risk Adjustment jobs?

States with the most job openings for Work From Home Medicare Risk Adjustment jobs include:

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The top searched job categories for Work From Home Medicare Risk Adjustment jobs are:

Work From Home Medicare Risk Adjustment jobs near you
Infographic showing various Work From Home Medicare Risk Adjustment job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, and 3% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $46,633 per year, or $22.4 per hour.

Risk Adjustment Lead - Platform Product Owner

Humana

Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

New

Humana rating

8.0

Company rating: 8.0 out of 10

Based on 267 frontline employees who took The Breakroom Quiz

170th of 315 rated insurance

Job description

Become a part of our caring community

This is a remote position.

You will connect Medicare Risk Adjustment business leaders, analytics resources, and IT delivery teams to maximize Risk Adjustment platform and technical portfolio value. You will apply technical understanding and consultative skills to translate and prioritize business needs into technical requirements that drive measurable outcomes. You will guide platform enhancements, identify opportunities, and escalate Risk Adjustment insights that may affect Stars.

You will exercise independent judgment, manage competing priorities, drive initiatives, and navigate technical budgeting processes that will deliver Risk Adjustment value. This position reports to the Director, Risk Management & Compliance.


Use your skills to make an impact

Required Qualifications

  • Bachelor's degree in a related field.
  • 3+ years of experience in system migrations, technical operations, or Agile product ownership.
  • Experience developing business cases and quantifiable value assessments.
  • Ability to translate complex business needs into technical requirements.

Preferred Qualifications

  • Advanced degree in a related field.
  • Knowledge of Medicare Risk Adjustment or Medicare Advantage regulations.
  • Experience with ADO or Jira.
  • Experience with epics, features, user stories, and acceptance criteria.
  • Six Sigma certification.
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$117,600 - $161,700 per year


This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 09-04-2026
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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About Humana

Sourced by ZipRecruiter

Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Louisville, KY, US

Year founded

1961

Social media

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