Hybrid Medical Director – Risk Adjustment

Posted last week

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About the role

  • Medical Director responsible for advancing risk adjustment strategies at CareMore Health. Leading clinical documentation efforts and healthcare provider education to ensure revenue integrity and compliance.

Responsibilities

  • Serve as the clinical expert responsible for advancing CareMore Health’s risk adjustment strategy
  • Guide providers in accurate and complete documentation of patient complexity and chronic conditions
  • Ensure compliance with CMS requirements while supporting enterprise revenue integrity
  • Focus on healthcare provider education, data-driven interventions, and cross-functional collaboration
  • Maximize risk score accuracy, reduce audit exposure, and align risk adjustment with clinical and business objectives

Requirements

  • MD or DO required, with active, unrestricted medical license
  • Board certification in Internal Medicine, Family Medicine, or related specialty strongly preferred
  • 8+ years of clinical practice experience, with at least 3–5 years in an expert-level role involving risk adjustment, clinical documentation improvement (CDI), or value-based care
  • Demonstrated success leading provider education and engagement programs to improve coding and documentation
  • Experience with Medicare Advantage and CMS risk adjustment methodology (HCC coding, RAF scoring, RADV audits)

Benefits

  • Offering effective Advanced Primary Care and Palliative Care
  • Personalized and compassionate care
  • Nationally recognized disease prevention and management programs

Job title

Medical Director – Risk Adjustment

Job type

Experience level

Lead

Salary

Not specified

Degree requirement

Postgraduate Degree

Location requirements

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