Medicare Advantage Risk Adjustment Improvement Specialist

Onsite or Remote

Flexible Hybrid

Work Schedule

Posted Date

01/08/2026

Salary Range
: $78500 - 163600 Annually

Employment Type

Duration

indefinite

Job #

28410

As the Medicare Advantage Risk Adjustment Performance Improvement Specialist, you will be responsible for:

• Serving as a Subject Matter Expert (SME) for risk adjustment with contracted IPAs
• Collaborating with IPAs on risk adjustment strategies to achieve health plan goals and KPIs
• Presenting and managing all risk adjustment programs offered by the health plan
• Act as a consultant and partner to the contracted IPAs
• Traveling to contracted IPAs within the Los Angeles County area

UCLAHealth salary range for this title code is $78,500-$163,600 annually. Please note that the department's target pay range is $95, annually.

We’re seeking a self-motivated, detail-oriented individual with:

Required:

• A Bachelor’s degree in Health Care Administration, Public Health, Population Health, Finance, Business Analytics or related field and/or equivalent experience
• Five or more years of experience in healthcare analytics, strategy, and/or consulting at an IPA or health plan level
• Three or more years of recent experience in risk adjustment
• Strong understanding of risk adjustment operations and V28 payment model and condition categories
• Knowledge of HIPAA regulations
• Project management and program management experience
  
  Excellent interpersonal skills to build relationships with clinical and non-clinical personnel
• Strong analytical and creative problem-solving skills
• Proficient in Microsoft Word, Excel, PowerPoint, and Outlook
• Reliable transportation to travel to and from contracted IPAs in Los Angeles County

Preferred:

• Three or more years of health plan experience, highly desired
• Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications
• Knowledge and understanding of ICD-10, CPT and CPT (II), and HCPCS