Medix™

Compensation

Full Description

Risk Adjustment Program Manager (Remote - California Employee) 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 Reporting to the Director of Risk Adjustment, this role is responsible for both program leadership and hands-on execution, including: • 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 Successful candidates bring a strong blend of program leadership, technical expertise, and collaboration skills, including: • 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 • Zone 2: Fresno area, Bakersfield, Central Valley (excluding Sacramento), Eastern California, Eureka 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)