Strategic Risk Adjustment & HCC Program Lead (Hybrid)

Bluestone-Physician-Services; Stillwater (MN); Hybrid; USD 120,000 - 138,000; Full time

Benefits offered by this job

Health Insurance

Short/Long-term Disability

Health Savings Account (HSA)

Flexible Spending Account (FSA)

401(k) with 4% match

10 Paid Holidays

Company devices

Job summary

Bluestone seeks a high-caliber Risk Adjustment & HCC Program Manager to optimize risk adjustment coding, bridging clinical, EHR, and RCM teams for compliant, patient-centered care.

This hybrid, full-time role reports to the SVP of Clinical Operations and requires 5+ years in risk adjustment; CRC preferred. Residency in MN, WI, or FL is required. Base salary: $120,000–$138,000, commensurate with experience.

Qualifications

• Minimum of 5 years in healthcare with risk adjustment coding optimization and HCC program management.
• CRC certification preferred; willingness to obtain CRC within an agreed timeframe if not already held.
• Knowledge of CMS-HCC risk adjustment models, ICD-10-CM coding, and regulatory compliance.

Responsibilities

• Oversee a team of 2 Risk Adjustment Coders; manage workload and performance.
• Design and manage standardized risk adjustment queries and processes.
• Collaborate with provider network, EHR, and RCM teams to ensure alignment.
• Ensure compliance with CMS/OIG guidelines and internal policies; conduct audits.
• Develop educational materials to improve clinical documentation integrity.
• Partner with analytics to monitor KPIs: HCC capture, query response, productivity.
• Continuously evaluate programs for efficiency and revenue integrity.

Skills

Leadership

Innovation & Strategy

Collaboration & Leadership

Drive for Success

Patient-Centric Focus

Influence & Authority

Matrixed Accountability

Analytical Mindset

Adaptability

Data & Informatics Fluency

Education

CRC (Certified Risk Adjustment Coder) – AAPC

CPC (Certified Professional Coder)

CCS (Certified Coding Specialist)

Job description

Bluestone seeks a high-caliber Risk Adjustment & HCC Program Manager to optimize risk adjustment coding, bridging clinical, EHR, and RCM teams for compliant, patient-centered care.

This hybrid, full-time role reports to the SVP of Clinical Operations and requires 5+ years in risk adjustment; CRC preferred. Residency in MN, WI, or FL is required. Base salary: $120,000–$138,000, commensurate with experience.