Sacramento, California, United States · On-site
$120k–$135k/yr
Job DetailsJob Location: SACRAMENTO, CA 95831Position Type: Full TimeSalary Range: $120,000.00 - $135,000.00 SalaryTravel Percentage: Up to 25%Job Shift: DayJob Summary: The Senior Risk Adjustment Factor (RAF) Specialist…
Skills: Risk Adjustment, HCC Coding, ICD-10, CMS Guidelines, Medicare Advantage
Sacramento, California, United States · On-site
$75k–$150k/yr
Benefits: Holidays off Closed Sundays Opportunities for overtime Generous commission 401(k) matching Competitive salary Dental insurance Flexible schedule Health insurance Paid time off Training & development Get Paid to…
Skills: Sales, Communication skills, Customer relationship management, Negotiation, CRM tools
Sacramento, California, United States · On-site
$18/hr–$20/hr
Company Description Care.com is a consumer tech company with heart. We’re on a mission to solve a human challenge we all face: finding great care for the ones we love. We’re moms and dads and pet parents. We have parents…
Skills: Childcare, CPR Certification, First Aid, English Communication, App-based Product Usage
Carmichael, California, United States · On-site
$109k–$175k/yr
Join Our National Network as a Part Time/Full Time Urgent Care Clinician (PA/NP) Are you ready to advance your career in a dynamic, supportive, and innovative healthcare environment? Join our team as a Part Time or Full …
Skills: Patient Assessment, Diagnosis, Laceration Repair, I&D, Splint Application
Sacramento, California, United States · On-site
$25/hr–$45/hr
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Skills: Office Management, DMV Paperwork, Title Transfers, Inventory Records, Scheduling
D'Ville Construction Inc. Sacramento, California, United States · On-site
$85k–$100k/yr
At D’ville Construction, we don’t just build structures – we build relationships, trust, and lasting value. D’ville Construction Inc. is the premier choice for tenant improvement (TI), medical facilities, OSHPD-compliant…
Skills: On-site Operations Management, Subcontractor Coordination, Quality Control, Construction Scheduling, Safety Compliance
Sacramento, California, United States · On-site
Benefits: Flexible schedule Opportunity for advancement Training & development Part-Time Caregiver – Flexible In-Home Senior Support Choose Your Shifts | Purpose-Driven Work | Sacramento Why This Role Fits Your Life Set …
Skills: Personal Care, Bathing and Grooming, Safe Transfers, Meal Preparation, Medication Reminders
Sacramento, California, United States · Remote OK
$80k–$100k/yr
REMOTE = Project Site and Main Office or Home Job Summary Provides construction related technical and administrative services on designated projects so that goals and objectives of project are accomplished. Essential Fun…
Skills: Technical Support, Project Communication, Document Tracking, Quantity Take-offs, Estimation
Sacramento, California, United States · On-site
$80k–$110k/yr
About the Role We are currently seeking a Project Engineer to support construction management services for our valued client's data center project. This position will work with a team of professionals, including the clie…
Skills: Construction Management, Budgeting, Cost Control, Vendor Management, Project Scheduling
Sacramento, California, United States · On-site
As a Medical/Surgical RN, you will play a vital role in delivering high-quality patient care, supporting recovery, and collaborating with a multidisciplinary team in a fast-paced clinical environment. Key Responsibilitie…
Skills: Patient Assessment, Medication Administration, Post-operative Care, Patient Education, Electronic Health Records
Sacramento, California, United States · On-site
$22/hr–$25/hr
Join VMD Corp, part of Xcelerate Solutions and a leader in providing passenger and checked baggage screening services at various airports across the United States. VMD Corp has an immediate need for Full-Time Airport Emp…
Skills: Security Screening, Customer Service, Critical Thinking, Identity Verification, Metal Detector Operation
Sacramento, California, United States · On-site
Job DetailsJob Location: N. Cali - Sacremento, CA 95823Position Type: Full-TimeEducation Level: 4 Year DegreeTravel Percentage: Up to 50% Job Shift: DayJob Category: Sales EngineeringBalluff is a global leader in sensor …
Skills: Industrial Automation Sales, Strategic Sales Planning, Account Management, Technical Presentations, Negotiation
Sacramento, California, United States · On-site
$70/hr–$70/hr
Camden Case Management provides personalized management services for individuals facing mental health and/or addiction challenges. Our team collaborates with clients at various stages of their healing journey, creating f…
Skills: Mental Health Coaching, Case Management, Crisis Intervention, Life Skills Training, Patient Advocacy
Citrus Heights, California, United States · On-site
Our Company All Ways Caring HomeCare Overview Who we are looking for: At All Ways Caring HomeCare our Caregivers play a crucial role in providing individualized care that suits the needs of each client in the comfort of …
Skills: Meal Preparation, Housekeeping, Companionship, Personal Hygiene Care, Transportation Assistance
Sacramento, California, United States · Hybrid
$118k–$154k/yr
Do you thrive in an imaginative and inventive environment? Are you someone who flourishes when part of a cohesive team where collaboration and ideas flow freely? Want to work for a firm that is taking concrete actions to…
Skills: Technical Leadership, Project Management, BIM, Revit, Construction Administration
Sacramento, California, United States · Remote OK
$128k–$150k/yr
Position Overview dormakaba is seeking an Architectural Sales Representative remote based in the greater Sacramento area. This individual is responsible for effectively promoting dormakaba’s entire North American portfol…
Skills: Sales, Architectural Sales, Relationship Management, Project Pipeline Development, Construction Specification
Carmichael, California, United States · On-site
$133k–$209k/yr
Primary Care NP/PA 4-Day Work Week, No Call, Holidays Off Eligible for a sign-on bonus or relocation assistance. Join Our National Network as a Primary Care Clinician in Sacramento, where affordable city living meets eas…
Skills: Patient History, Physical Examinations, Women's Health Services, Treatment Planning, X-ray Interpretation
Carmichael, California, United States · On-site
$260k–$367k/yr
Primary Care Physician, 4-Day Work Week, No Call, Holidays Off Eligible for a sign-on or relocation bonus. Join Our National Network as a Primary Care Physician in Sacramento, where affordable city living meets easy acce…
Skills: Patient-Centered Care, Physical Examinations, Women's Health Services, Treatment Planning, X-ray Interpretation
Carmichael, California, United States · On-site
$67/hr–$93/hr
Join Our National Network as a Per Diem Urgent Care Clinician (PA/NP) Are you ready to advance your career in a dynamic, supportive, and innovative healthcare environment? Start as a per diem clinician and discover endle…
Skills: Patient Assessment, Diagnosis, Urgent Care Procedures, Wound Closures, I&D
Sacramento, California, United States · On-site
$78k–$90k/yr
Treatment Center Director/Program Director BAART Programs is looking for an accountable, process oriented and efficient leader of operations for our Opiate Treatment Program. A great Treatment Center Director leads a div…
Skills: Clinical Operations Management, Staff Supervision, Regulatory Compliance, Budget Management, Strategic Thinking
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The Senior RAF Specialist optimizes member Risk Adjustment Factor scores through accurate diagnosis coding and clinical documentation review. They lead provider education, manage audit programs, and collaborate with care management teams to ensure CMS compliance and accurate reimbursement.
Requires 5-8 years of experience in Risk Adjustment or HCC coding and a professional certification such as CPC, CRC, or CPMA. A high school diploma is required, while a degree in Health Information Management or a related field is preferred.
Job DetailsJob Location: SACRAMENTO, CA 95831Position Type: Full TimeSalary Range: $120,000.00 - $135,000.00 SalaryTravel Percentage: Up to 25%Job Shift: DayJob Summary:
The Senior Risk Adjustment Factor (RAF) Specialist supports Vivant’s risk adjustment initiatives within the IPA’s Medicare Advantage line of business. This advanced role ensures accurate and complete documentation and coding of diagnoses to optimize member Risk Adjustment Factor (RAF) scores, supporting quality patient care and accurate reimbursement under CMS guidelines. The Senior RAF Specialist collaborates closely with providers, coders, and care management teams to identify and implement opportunities for RAF improvement through education, chart reviews, and data analysis.
Own coding and Monthly Membership Report reconciliation.
Lead provider education (training, specialty tip-sheets, and targeted on-on-one feedback).
Run/own audit program (sampling, error trending, corrective action, and RADV-readiness support).
Lead audit pass rates, sustained provider documentation improvement, RAF accuracy lift, reduced audit risk, and education completion/impact.
Review and analyze clinical documentation and diagnosis coding to ensure compliance with CMS-HCC (Hierarchical Condition Category) guidelines.
Monitor and report RAF score trends across assigned providers, physician groups, and Medicare populations.
Conduct retrospective and prospective chart reviews to identify coding gaps, suspected conditions, and missed opportunities.
Partner with provider offices to ensure accurate submission of encounter data and supplemental claims.
Work collaboratively with health plan and IPA coding teams to reconcile risk score discrepancies and validate data accuracy.
Support provider education programs on compliant documentation and coding practices (HCC, ICD-10, and CMS Risk Adjustment methodology).
Compile RAF performance dashboards and support audit and reconciliation processes related to Medicare risk adjustment.
Participate in outreach campaigns to ensure timely completion of annual wellness visits and other risk-capture opportunities.
Stay current with CMS updates, HCC model changes, and risk adjustment regulatory requirements.
Assist in developing workflow improvements for documentation, coding, and data submission.
Performs related duties consistent with the scope and intent of the position.
Regular attendance.
Travel as required
Enforces Company policies and safety procedures.
Regularly updates job knowledge by participating in educational opportunities, reading professional publications, maintaining professional networks, and participating in professional organizations.
Maintain IPA, Health Plan compliance standards.
QualificationsCompetencies
Minimum of 5-8 years of experience in Risk Adjustment, HCC coding, or Medicare Advantage operations.
3-5 years of Independent Physician Association (IPA) or health plan environment preferred.
Cozeva experience preferred.
Strong knowledge of ICD-10, HCC risk adjustment models, CMS guidelines, and Medicare Advantage programs.
Proficiency in EMR/EHR systems, risk adjustment analytics platforms, and Microsoft Office Suite (Excel, Power BI preferred).
Ability to analyze data, identify trends, and develop actionable insights.
Excellent communication, both oral and written, and interpersonal skills for provider education and collaboration.
Excellent attention to detail and ability to document information accurately.
Excellent active listening skills.
Ability to solve advanced-level problems with minimal supervision.
Ability to multi-task, exercise excellent time management, and meet multiple deadlines.
Ability to provide and receive constructive job and/or industry related feedback.
Ability to maintain confidentiality and appropriately share information on a need-to-know basis.
Ability to exercise sound discretion and strict maintenance of confidentiality of all confidential and sensitive communications and information.
Ability to consistently deliver excellent customer service.
Self-motivated with strong organizational, multi-tasking, planning, and follow up skills.
Ability to work independently as well as in a team environment.
Ability to present self in a professional manner and represent the Company image.
Ability to effectively and positively work in a dynamic, fast-paced team environment and achieve objectives.
Demonstrate commitment to the organization’s mission.
Typing speed of 40 wpm or more is a plus.
Must have the ability to quickly learn and use new software tools.
Must have advanced-level skills using e-mail applications.
High School Diploma or GED required.
Associate’s or Bachelor’s degree in Health Information Management, Health Administration, Nursing, or related field preferred.
Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), Certified Professional Medical Auditor (CPMA), or equivalent credential required.
Must have an active and unrestricted California Driver’s license.
Must have auto insurance and reliable transportation.
Travel
The incumbent may travel up to 25% of the time.
This job operates in a professional office environment. This role routinely uses office equipment such as computers, phones, photocopiers, scanners and filing cabinets.
Bringing Healthcare to Life
Vivant Health is the trusted leader in healthcare and innovation, serving our community for over 30 years. Our Vivant Health family of companies is mission-driven to inspire hope and promote health equity by delivering integrated clinical practice, leveraging advanced healthcare technology, providing innovative care solutions, and fostering strong partnerships among health plans, patients, and care providers. Vivant Health serves over 300,000 patients, has partnerships with eight premier health plans and with all community Federally Qualified Health Centers (FQHCs), and an integrated suite of eight core coordinated programs and services, all cared for by our network of 6,000+ providers. We are committed to “Bringing Healthcare to Life” through equitable access for all.
Offices: 7311 Greenhaven Dr, Sacramento, California 95831, US
