Risk Adjustment Program Manager; Remote

Position: Risk Adjustment Program Manager (Remote) - 244010
Location: California

This range is provided by Medix™. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Direct message the job poster from Medix™

Base pay range

$48.19/hr - $84.73/hr

Regional Recruitment Advisor V - West at Medix™ About the Role

This is a Defined Term, full-benefits position designed to support long-term, project-based work within the Risk Adjustment department. The role is expected to continue through December 31, 2026
, with duration tied to business and project needs.

We are seeking a Risk Adjustment Program Manager to join our Risk Adjustment team and help design, implement, and manage programs that drive accurate coding, compliant reimbursement, and data-driven decision‑making.

What You’ll Do

• Designing, implementing, and managing Risk Adjustment programs and overseeing related departmental initiatives
• Leading small to large‑scale projects that support organizational goals and measurable business outcomes
• Serving as a Risk Adjustment subject matter expert
  , providing guidance and expertise across the organization

About the Team

The Risk Adjustment team is a growing, highly specialized group that plays a vital role in supporting accurate coding, appropriate reimbursement, and actionable insights. The team works closely with clinical, operational, and external partners to optimize risk adjustment performance across Medicare and Medi‑Cal programs. The work directly supports improved member outcomes, provider success, and regulatory compliance.

The Ideal Candidate

• Proven experience building, scaling, and managing risk adjustment programs in healthcare settings
• Strength in provider education and engagement
  , including training development, facilitation, and addressing documentation challenges
• Ability to partner effectively with clinical, operational, and technical teams to achieve shared objectives
• Self‑motivated and proactive, with strong project ownership and prioritization skills
• Excellent presentation and communication abilities
  , able to deliver clear updates and training to diverse audiences
• Deep commitment to compliance, clinical integrity, and ethical risk capture practices
• Medicare and Medi‑Cal experience strongly preferred

What You’ll Need to Be Successful

Knowledge of:

• Research, analysis, and reporting methodologies
• Risk adjustment program management principles and best practices
• Healthcare data structures, including member, claims, clinical, and provider data
• Applying analytics and insights to support financial and strategic decisions
• Project management frameworks and methodologies

Ability to:

• Analyze trends and data to inform risk adjustment strategies and tactical decisions
• Serve as a subject matter expert for complex risk adjustment initiatives
• Lead the development and execution of programs, workflows, policies, and systems
• Manage multiple initiatives simultaneously while meeting timelines and deliverables
• Provide leadership, facilitate meetings, and guide cross‑functional collaboration

Education & Experience

• Bachelor’s degree in Finance, Business, Healthcare Administration, Mathematics, Statistics
  , or a related field
• Minimum of eight years of progressively responsible experience in healthcare finance or analytics
• Includes at least three years supporting or managing risk adjustment programs
• A Master’s degree may substitute for two years of required experience
• Equivalent combinations of education and experience will be considered

Compensation is based on qualifications, experience, internal equity, market conditions, and geographic location.

Typical Zone Classifications

• Zone 1: Bay Area, Sacramento, Los Angeles area, San Diego area

Pay Ranges by Location

• Zone 1 (Monterey, San Benito, Santa Cruz): $110,160 – $176,259 annually ($52.96–$84.73 hourly)
• Zone 2 (Mariposa, Merced): $100,246 – $160,410 annually ($48.19–$77.12 hourly)

Seniority level

Mid‑Senior level

Employment type

Full‑time

Job function

Analyst, Finance, and Strategy/Planning

Industries

Hospitals and Health Care and Insurance

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