• Auditor , Risk Adjustment

    Molina Healthcare (Albuquerque, NM)
    …**Knowledge/Skills/Abilities** * Assist in the daily operations of all aspects of risk adjustment data validation related activities, including, but not limited ... file transmissions, and adherence to applicable timelines * Support all risk adjustment audit related projects to ensure goals, objectives, milestones and… more
    Molina Healthcare (07/25/25)
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  • HCC Risk Adjustment Auditor

    Datavant (Santa Fe, NM)
    …coded in a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been...and verbal communication skills, ability to work in a remote environment and time management skills + Working knowledge… more
    Datavant (08/01/25)
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  • Auditor , HCC Risk Adjustment

    Datavant (Denver, CO)
    …educational and life experiences to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical records ... using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical… more
    Datavant (08/08/25)
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  • Director, Clinical Data Acquisition (HEDIS…

    Molina Healthcare (St. Petersburg, FL)
    …monitoring, and oversight of all chart collection for HEDIS, or HEDIS-like projects, Risk Adjustment , Risk Adjustment Data Validation, and ... that support business objectives. + HEDIS Operations experience. + Risk Adjustment and Data Validation experience. +...be preferred for specific roles) * Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you… more
    Molina Healthcare (08/21/25)
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  • Physician Coding Auditor

    MedKoder (Mandeville, LA)
    …company offers services including inpatient and outpatient facility coding, medical risk adjustment management, DRG coding management, coding education, clinical ... coders throughout the United States, MedKoder emphasizes coding excellence, remote -work flexibility, and a positive workplace culture, earning high employee… more
    MedKoder (09/11/25)
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  • Senior Auditor , Global Internal Audit…

    Bristol Myers Squibb (Princeton, NJ)
    …in their personal lives. Read more: careers.bms.com/working-with-us . Position Summary The Senior Auditor in GIA will work in a team environment to plan and execute ... dynamic risk -based audits and identify value-added recommendations to strengthen Company...key third-party outsourcing arrangements. Throughout the audits, the Senior Auditor will have the opportunity to interact with senior… more
    Bristol Myers Squibb (08/16/25)
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  • IT Auditor

    Aston Carter (Rosemont, IL)
    …involves working closely with audit team members, internal clients, and other risk management and compliance functions. The position requires occasional travel to ... + Applied knowledge of accounting concepts, audit methodologies, and risk -based auditing techniques. + Familiarity with The IIA's International...with three days in the office and two days remote , based in Rosemont, IL. We provide a comprehensive… more
    Aston Carter (09/13/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Phoenix, AZ)
    …analyze large data sets + Knowledge of healthcare compliance, mainly primary care and risk adjustment , pharmacy knowledge a plus + Certified Coder (CPC, CRC, ... to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This team ensures that healthcare providers align… more
    Humana (08/23/25)
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  • Compliance Auditing Specialist- Remote

    WMCHealth (Valhalla, NY)
    …Applicant link Job Details: Job Summary: Serves as an internal expert on Risk Adjustment and Hierarchical Conditions Categories (HCC) coding. Specific duties ... Compliance Auditing Specialist- Remote /Hybrid available Company: NorthEast Provider Solutions Inc. City/State:...with one or more of the following credentials: Certified Risk Coder (CRC), Certified Professional Coder certification (CPC), Certified… more
    WMCHealth (09/12/25)
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  • Director, GMP And GDP Audits

    Bristol Myers Squibb (New Brunswick, NJ)
    …and implementing a strategic global audit program to proactively identify risk areas while aligning with company objectives and regulatory requirements. They ... the optimal audit strategy in accordance with company objectives to proactively identify risk areas. + Lead, mentor, and develop a team of GMP/GDP auditors,… more
    Bristol Myers Squibb (09/11/25)
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  • Clinical Documentation Specialist, Second Reviewer

    SSM Health (MO)
    …scoring. + Collaborates with others regardingclinical documentation improvement (CDI) and risk adjustment (mortality) findings. + Maintains knowledge of Centers ... **It's more than a career, it's a calling.** MO- REMOTE **Worker Type:** Regular **Job Summary:** Performs as...vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete… more
    SSM Health (09/06/25)
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  • Senior Data Quality / Integrity Engineer

    Humana (Indianapolis, IN)
    …status and improvement opportunities to markets and Providers. + Partner with Medicare Risk Adjustment (MRA) and vendors to establish data feeds for STARs ... and nonstandard supplemental data audit with NCQA and DTS auditor . **Use your skills to make an impact** **Required...Go365 perks for well-being Travel: While this is a remote position, occasional travel to Humana's offices for training… more
    Humana (09/12/25)
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