Senior Manager, Risk Adjustment

Job overview

The Senior Manager, Risk Adjustment position is listed in Pasadena, CA. Compensation is $100,000–$150,000 per year. The role supports the Quality Improvement and Risk Adjustment department across affiliated health plans, medical groups, and management services functions. The manager leads risk adjustment operations, analytics, reporting, and compliance across Medicare Advantage, Marketplace, and related programs. The role helps improve risk score accuracy, provider engagement, data integrity, audit readiness, and enterprise decisions related to financial forecasting and coding accuracy.

What you'll do

• Lead risk adjustment strategy and operations across lines of business
• maintain expertise in CMS-HCC, HHS-HCC, and RxHCC models
• oversee staff and cross-functional teams
• develop reporting and business intelligence tools
• analyze documentation, coding, and encounter data gaps
• collaborate with providers and vendors
• monitor vendor performance
• translate regulatory guidance into operational processes
• lead audit readiness
• use analytics and forecasting
• align risk adjustment with HEDIS and quality initiatives
• train staff and providers
• oversee data quality and regulatory compliance.

What we're looking for

Skills & competencies

senior manager

risk adjustment

healthcare analytics

medicare advantage

cms-hcc

hhs-hcc

rxhcc

radv audits

pasadena ca

$100k-$150k

full-time

regulatory compliance

Work arrangement

• Weekend coverage required

Why this role

Requires a bachelor’s degree or equivalent combination of education and relevant experience, 5–7 years of risk adjustment experience, and at least 3 years of supervisory or managerial experience.

About the employer

Imperial Management Administrators Services Inc is hiring for this role. Industry: Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds. Sector: 52.