Medical Director – Risk Adjustment
CareMore Health
full-time
Posted on:
Location Type: Hybrid
Location: Cerritos • Arizona • California • United States
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Job Level
About the role
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
risk adjustmentclinical documentation improvementHCC codingRAF scoringRADV audits
Soft skills
provider educationcross-functional collaborationdata-driven interventionsleadership
Certifications
MDDOboard certification in Internal Medicineboard certification in Family Medicine