• Quality & Risk Adjustment

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …Blue Cross and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career ... -performance consultation team, this role * Identifies opportunities for provider groups to improve performance on quality ...-facing or leadership-facing experience * Knowledge of Health Care Quality measures * Certified Risk Adjustment more
    Blue Cross and Blue Shield of Minnesota (09/30/25)
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  • Director Risk Adjustment

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Director Risk Adjustment and Quality Analytics - Actuarial Location: Hybrid ... Will Have We are looking for a Director of Risk Adjustment and Quality Analytics...and maintenance of dashboards to monitor risk adjustment initiatives and outcomes. * Collaborates with provider more
    Blue Cross and Blue Shield of Minnesota (11/01/25)
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  • Risk Adjustment QA Consultant

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …are ready to make a difference, join us. The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at BCBSMN, you'll play a critical ... protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Risk Adjustment QA Consultant Location: Hybrid | Eagan, Minnesota Career… more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
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  • Auditor, HCC Risk Adjustment Coding…

    Datavant (St. Paul, MN)
    …and life experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code ... using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical… more
    Datavant (11/07/25)
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  • Supervisor, Risk Adjustment Auditing

    Datavant (St. Paul, MN)
    …Auditing Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring production and ... and time off requests. + Receive, merge and track quality , productivity, and feedback for all team members. +...Provide coaching and feedback on achieving production and quality standards of the role. + Report trends for… more
    Datavant (10/19/25)
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  • Director of Value Performance Submissions…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …on key findings. * Direct research, analyses, and interpretation of risk adjustment and quality data and provide technical assistance to other ... Job Duties * Develop, lead, and provide strategic direction for a high performing team...for maintaining, executing, and evaluating initiative impacts using the risk adjustment and quality analytics… more
    Blue Cross and Blue Shield of Minnesota (11/20/25)
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  • Client Coding Project Manager - Full Time - Remote

    Datavant (St. Paul, MN)
    …will provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for daily operations ... role in ensuring coding compliance and accuracy + Monitor the performance of the Risk Adjustment Operations both internally and with coding vendors + Provides… more
    Datavant (10/09/25)
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  • Clinical Documentation Improvement Specialist…

    Bluestone Physician Services (Stillwater, MN)
    …and other clinical staff to educate them on the importance of accurate documentation for risk adjustment purposes. + Provide ongoing training and support to ... thorough patient chart reviews to identify opportunities for providers to capture risk adjustment diagnostic codes accurately. The successful candidate will play… more
    Bluestone Physician Services (10/19/25)
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  • Director of Value Performance Quality

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …identify risks and opportunities for improvement. * Collaborate with Pharmacy, Risk Adjustment , Network Management, Care Management, Member Experience, Medical ... requirements into actionable strategies to operationalize across departments. * Provide executive-level reporting and communication on quality performance to… more
    Blue Cross and Blue Shield of Minnesota (11/10/25)
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  • Senior Coding Educator

    Humana (St. Paul, MN)
    provider . The Senior Coding Educator is responsible for creating and executing the risk adjustment strategy for each provider groups. + Analyzes data and ... Risk Coder (CRC) + Experience interacting with healthcare providers + Medicare Risk Adjustment knowledge + Analyzing data to build unique education strategies… more
    Humana (11/20/25)
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  • ICITAP Corrections Advisor

    Amentum (St. Paul, MN)
    …for the purpose of verifying and assessing the home situation and the offender's adjustment while under supervision. + Provide information on the analysis and ... enhancing human rights in developing countries. Amentum is the contract service provider to the DOJ ICITAP and Overseas Prosecutorial Development, Assistance and… more
    Amentum (09/03/25)
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  • Senior Product Manager

    Humana (St. Paul, MN)
    …Qualifications** + Bachelors Degree + Knowledge and/or experience within the Stars Organization, Risk Adjustment and/or Provider + PMP or CAPM Certification ... include but not limited to Intake, Charter, Governance Structure, Project Plan, Risk /Issues Tracking, etc. + Analyze project portfolio to ensure project updates,… more
    Humana (11/19/25)
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  • Financial Analytics Lead

    Humana (St. Paul, MN)
    …+ Lead financial analytics projects, with a focus on outcomes of Medicare risk adjustment operations and initiatives. + Work independently to analyze historical ... insights for non-technical stakeholders. **Preferred Qualifications** + Experience with Medicare Risk Adjustment programs and/or CMS datasets. + Familiarity with… more
    Humana (11/06/25)
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  • Operations Engineer, AMZL Start-Up Execution

    Amazon (Eagan, MN)
    …ensuring that contracted resources meet schedule, budgetary, safety and driving quality targets; analyzing and deep diving systems performance, inventing and ... throughput and safety qualifications. Simplify, optimize, remove bottlenecks and provide feedback while resolving difficult system problems or technical… more
    Amazon (10/02/25)
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  • AVP- Complex Claim Specialist

    Travelers Insurance Company (St. Paul, MN)
    …and/or complex claims, in multiple jurisdictions, in accordance with Best Practices. Provide quality claim handling and superior customer service on assigned ... and file exposure is greater than $2 million. + Provide quality customer service and ensure file...activities required to effectively evaluate claims, such as Subro, Risk Control, nurse consultants and fire or fraud investigators… more
    Travelers Insurance Company (11/12/25)
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  • Follow-up Senior Program Delivery Professional…

    Humana (St. Paul, MN)
    …in Business Administration or a related field + PMP certification a plus + Stars, Risk Adjustment , or IHWA experience + Knowledge and experience in health care ... to internal resources for Humana follow-up. Primary Responsibilities: + Provide input and operationalize new follow-up programs + Point...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families,… more
    Humana (11/20/25)
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