Top 29 Risk management Jobs in Brooksville, Fl

Director, Medicare Risk Adjustment
access health care —Spring Hill, FL
- From $85,000 a year
- Full-time
- Background check
- Management
- RN License
- Health savings account
- Health insurance
Quick Apply
3d
Quality CDI
Access Healthcare Physicians, LLC —Spring Hill, FL
- From $20 an hour
- Full-time
- Background check
- RN License
- Mid-level
- Health savings account
- AD&D insurance
Quick Apply
DIRECTOR OF CLINICAL RISK MANAGEMENT AND QUALITY ASSURANCE
Confidential —Spring Hill, FL
- $87,289.60 - $105,122.96 a year
- Full-time
- Background check
- Management
- RN License
- Health insurance
- Dental insurance
Quick Apply
DIRECTOR OF CLINICAL RISK MANAGEMENT AND QUALITY ASSURANCE
access health care —Spring Hill, FL
- $87,289.60 - $105,122.96 a year
- Full-time
- Management
- RN License
- Writing skills
- Health insurance
- Dental insurance
Quick Apply
3d
Risk Manager/Staff Development (RN) - FT Risk Manager/Staff Development Coordinator (RN)
Northbrook Center for Rehabilitation and Healing —Brooksville, FL
- Full-time
- Background check
- CPR Certification
- Nursing
- Disability insurance
- Health insurance
Quick Apply
Director of Safety Risk Management
Steadfast —San Antonio, FL
- Full-time
- Spanish
- English
- 8 years
- Paid holidays
- Health insurance
Quick Apply
Leasing Ambassador (BTR)
Maymont Homes —Land O' Lakes, FL
- Full-time
- Microsoft Excel
- Organizational skills
- Experience equivalent to degree accepted
- Paid time off
- 401(k) matching
Quick Apply
Dental Director
Premier Community Healthcare Grp. —Dade City, FL
- Background check
- BLS Certification
- HIPAA
- Dental insurance
Quick Apply
7d
Shift Leader - Spring Hill
Wingstop Restaurant Inc. —Spring Hill, FL
- Part-time
- Mid-level
- Supervising experience
- Mentoring
Quick Apply
14d
Maintenance Technician II - Mary W. Sierra Family YMCA
Tampa Metropolitan Area YMCA —Wesley Chapel, FL
- $22 - $25 an hour
- Weekends as needed
- Customer service
- Mid-level
- 3 years
- Paid holidays
- Dental insurance
Quick Apply
Maintenance Technician - Ascend Angeline
RangeWater Residential, LLC —Land O' Lakes, FL
- Weekends as needed
- Word processing
- Residential
- High school diploma or GED
- Paid parental leave
- Paid holidays
Quick Apply
10d
Welcome Center Advisor - East Pasco Family YMCA
Tampa Metropolitan Area YMCA —Zephyrhills, FL
- $14 - $15 an hour
- Part-time
- Marketing
- Computer literacy
- Writing skills
- Employee assistance program
- 403(b)
Quick Apply
Youth Sports Site Supervisor -East Pasco Family YMCA
Tampa Metropolitan Area YMCA —Zephyrhills, FL
- $15 - $17 an hour
- Part-time
- Management
- Mid-level
- High school diploma or GED
- Employee assistance program
- 403(b)
Quick Apply
Assistant Nurse Manager Emergency Department Nights | Dade City
AdventHealth Dade City —Dade City, FL
- $33.99 - $63.22 an hour
- Full-time
- Background check
- CPR Certification
- Nursing
- Paid parental leave
- Disability insurance
Family Programming Lead Attendant - Mary W. Sierra Family YMCA
Tampa Metropolitan Area YMCA —Wesley Chapel, FL
- From $15 an hour
- Part-time
- Classroom
- Management
- Adults
- Employee assistance program
- 403(b)
Quick Apply
Youth Sports Site Supervisor - Mary W. Sierra Family YMCA
Tampa Metropolitan Area YMCA —Wesley Chapel, FL
- $15 - $17 an hour
- Part-time
- Management
- Mid-level
- High school diploma or GED
- Employee assistance program
- 403(b)
Quick Apply
Certified Group Exercise Instructor (Zumba, Cycle, Les Mills, Aqua) - Mary W. Sierra Family YMCA
Tampa Metropolitan Area YMCA —Wesley Chapel, FL
- $20 - $25 an hour
- Weekends as needed
- 18 years or older
- Mid-level
- Ability to lift 50 pounds
- Employee assistance program
- 403(b)
Quick Apply
Swim Instructor - East Pasco Family YMCA
Tampa Metropolitan Area YMCA —Zephyrhills, FL
- From $14 an hour
- Part-time
- CPR Certification
- BLS Certification
- Ability to lift 50 pounds
- Employee assistance program
- 403(b)
Quick Apply
FBI Special Agent: Risk Management & Threat Analysis Expertise
Federal Bureau of Investigation —United States
- $103,236 - $133,200 a year
- Full-time
- Doctoral degree
- Master's degree
- Analysis skills
14d

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Claims Representative - Tampa, FL
Federated Mutual Insurance Company —Tampa, FL
Communicate with clients, physicians, attorneys, contractors and others to ensure claims are resolved in a prompt, fair, and courteous way.
$63,800 - $78,000 a year
Patient Insurance Advocate- Brooksville, Fl.
HealthFund Solutions LLC —Brooksville, FL
Valid driver’s license, clean driving record, and active auto insurance. Manage a high volume of outreach calls. Medical, Dental, and Vision Insurance.
$21 an hour
Quick Apply
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As a part of the 2027 Asset & Wealth Management Risk Full Time Analyst Program, you will collaborate with industry experts to identify, assess, and manage risks…
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risk management jobs near brooksville, fl

Director, Medicare Risk Adjustment

access health care
Spring Hill, FL

Quick Apply

Job Details

Full-time
From $85,000 a year
3 days ago

Benefits

Health savings account
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Life insurance
Retirement plan

Qualifications

Teamwork
Management
Medicare
Managed care
RN License
Managed care organization experience
Spreadsheets
CMS
HIPAA
Certified Professional Coder
CMS regulatory compliance
Bachelor's degree
Health insurance knowledge
Medicare regulations
Leading team collaboration initiatives
Centers for Medicare & Medicaid Services (CMS) billing regulations
Presentation creation
Productivity software
Clinical documentation standards
Cross-functional team management
Process management
Cross-functional communication
HEDIS

Full Job Description

Director, Medicare Risk Adjustment

Location: Spring Hill, FL
Work Arrangement: On-Site Only (No Remote Work Available)

About the Role

Ultimate Health Plans is seeking a strategic and results-driven Director, Medicare Risk Adjustment to lead and optimize our Medicare Advantage Risk Adjustment program. This leadership role is responsible for developing and executing strategies that improve risk adjustment accuracy, financial performance, provider engagement, and regulatory compliance across our provider network.

The ideal candidate will possess extensive Medicare Advantage experience, deep knowledge of CMS Risk Adjustment methodologies, and a proven ability to lead cross-functional teams while driving measurable performance outcomes.

Key ResponsibilitiesStrategic Leadership

Lead the overall Medicare Risk Adjustment strategy to maximize program performance and financial outcomes.
Develop and implement initiatives that improve risk score accuracy, documentation quality, and coding compliance.
Monitor, analyze, and report on Medicare Advantage performance metrics and financial results.
Identify opportunities for improvement and implement action plans to achieve organizational goals.

Provider Engagement & Education

Serve as the primary point of contact for participating providers, physician groups, and Independent Practice Associations (IPAs) regarding risk adjustment performance.
Conduct provider meetings and deliver education focused on documentation improvement, coding accuracy, and CMS compliance.
Develop targeted provider education programs based on coding trends, audit results, and performance data.
Foster strong relationships with providers and key stakeholders to support achievement of risk adjustment objectives.

Coding, Compliance & Audit Management

Ensure compliance with CMS Risk Adjustment regulations and guidelines.
Partner with Risk Coding teams to validate diagnosis capture and accurate submission within CMS timelines.
Audit provider documentation and ICD-10 coding practices to ensure compliance with CMS Risk Adjustment requirements.
Lead coding audit activities, including RADV audits and corrective action initiatives.
Oversee remediation efforts and resubmissions for failed CMS submissions when necessary.
Protect the confidentiality of member information and maintain HIPAA compliance.

Operational Excellence

Collaborate with Quality, Compliance, Coding, Performance, and Clinical teams to achieve organizational objectives.
Lead cross-functional projects and workgroups to support risk adjustment and Medicare Advantage performance goals.
Identify operational efficiencies and implement process improvements.
Manage timelines, deliverables, risks, and stakeholder communications across multiple initiatives.

Required QualificationsEducation & Certifications

Bachelor's degree required; Master's degree preferred.
Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) certification required.

Experience

5+ years of experience in Medicare Advantage, Risk Adjustment, or Health Plan Operations.
3+ years of leadership or management experience.
Demonstrated success in Medicare Risk Adjustment and Quality programs.

Knowledge & Skills

Strong knowledge of CMS-HCC Risk Adjustment, Risk Adjustment Data Validation (RADV), and Medicare Advantage regulations.
Understanding of HEDIS and healthcare quality programs.
Working knowledge of ICD-10, CPT, and HCPCS coding systems.
Experience with electronic medical records (EMR) platforms such as eClinicalWorks (eCW) and Athenahealth.
Advanced proficiency in Microsoft Excel, Word, and PowerPoint.
Strong analytical, organizational, and problem-solving skills.
Excellent written, verbal, and presentation skills.
Ability to manage multiple priorities in a fast-paced environment.
Proven ability to build relationships and collaborate effectively with physicians, executives, and operational teams.

Why Join Ultimate Health Plans?

Opportunity to lead a high-impact Medicare Advantage Risk Adjustment program.
Collaborative and mission-driven culture.
Competitive compensation and benefits package.
Ability to drive measurable outcomes that improve member care and organizational performance.

Apply today if you're a Medicare Advantage Risk Adjustment leader who thrives on driving results, building provider partnerships, and ensuring coding excellence.

Job Type: Full-time

Pay: From $85,000.00 per year

Benefits:

401(k)
401(k) matching
Dental insurance
Employee assistance program
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Retirement plan
Vision insurance

Experience:

Management: 1 year (Preferred)
Medicare Risk: 1 year (Preferred)
HEDIS: 1 year (Required)
Managed care: 1 year (Required)

License/Certification:

RN License (Required)

Ability to Commute:

Spring Hill, FL 34606 (Required)

Ability to Relocate:

Spring Hill, FL 34606: Relocate before starting work (Required)

Work Location: In person

Quick Apply

Refine Your Search

risk management jobs in brooksville, fl

Director, Medicare Risk Adjustment

Quality CDI

DIRECTOR OF CLINICAL RISK MANAGEMENT AND QUALITY ASSURANCE

DIRECTOR OF CLINICAL RISK MANAGEMENT AND QUALITY ASSURANCE

Risk Manager/Staff Development (RN) - FT Risk Manager/Staff Development Coordinator (RN)

Director of Safety Risk Management

Leasing Ambassador (BTR)

Dental Director

Shift Leader - Spring Hill

Maintenance Technician II - Mary W. Sierra Family YMCA

Maintenance Technician - Ascend Angeline

Welcome Center Advisor - East Pasco Family YMCA

Youth Sports Site Supervisor -East Pasco Family YMCA

Assistant Nurse Manager Emergency Department Nights | Dade City

Family Programming Lead Attendant - Mary W. Sierra Family YMCA

Youth Sports Site Supervisor - Mary W. Sierra Family YMCA

Certified Group Exercise Instructor (Zumba, Cycle, Les Mills, Aqua) - Mary W. Sierra Family YMCA

Swim Instructor - East Pasco Family YMCA

FBI Special Agent: Risk Management & Threat Analysis Expertise

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