- LA Care Health Plan (Los Angeles, CA)
- Enterprise Risk Adjustment Analyst III Job Category: Accounting/Finance Department: Risk Adjustment Strategies & Initiatives Location: Los Angeles, ... support the safety net required to achieve that purpose. Job Summary The Enterprise Risk Adjustment Analyst III provides a key leadership role in the Risk… more
- University of Utah Health (Murray, UT)
- …responsibility, integrity, quality and trust that are integral to our mission. EO/AA_ + Risk Adjustment Analyst position provides support for our health ... plan's risk adjustment program. + This role is responsible for analyzing...role is responsible for analyzing medical claims, encounter, and risk adjustment targeting data to identify opportunities… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior ACA Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity ... of key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of HHS risk score methodology, … more
- MVP Health Care (Rochester, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a **Sr. Risk Adjustment Analyst ** to join #TeamMVP. This is the ... at once while achieving desired results required + Knowledge of CMS risk adjustment and reinsurance payment processes and audits for Medicare and Commercial… more
- Baylor Scott & White Health (Austin, TX)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... to provide insight to decision-makers. This role supports program management activities around risk adjustment data management and submissions to CMS. This role… more
- Fallon Health (Worcester, MA)
- …fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Risk Adjustment Analyst (RAA) will be a SME for the ... MassHealth risk adjustment model(s) and related data submission requirements. This role will be familiar with all revenue streams relevant to the product line(s)… more
- Elevance Health (FL)
- ** Risk Adjustment Actuarial Analyst II - Advanced Analytics** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days ... for employment, unless an accommodation is granted as required by law._ The ** Risk Adjustment Actuarial Analyst II - Advanced Analytics** is responsible for… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Risk Adjustment Clinical Auditor/ Analyst position in the Medicare department. This is a full time position ... remote.. The Clinical Auditor/ Analyst is an integral part of the Risk Adjustment Department and is responsible for reviewing and auditing medical records for… more
- Centene Corporation (Tallahassee, FL)
- …from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on the ... of compliance issues. Facilitates and leads external audits related to Risk Adjustment processes. Ensures visibility by way of reporting out audit deliverables… more
- Humana (Louisville, KY)
- …hybrid based on business discretion. The MRA Finance team supports Humana's Medicare Risk Adjustment business area. The Finance team develops revenue and ... in Medicare regulations and payment models, monitors and reports on risk adjustment data submissions, and supports operations. This role will be responsible… more
- UCLA Health (Los Angeles, CA)
- Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... Serve as a key departmental resource for application use related to risk adjustment coding guidelines and gap closure reporting. Salary Range: $78,500 -… more
- Highmark Health (Lansing, MI)
- …for efficiencies. May provide guidance to Associate level employees. **This role sits within our Risk Adjustment team - it is a remote based role - looking for ... some claims experience and looking to become familiar with risk adjustment .** **ESSENTIAL RESPONSIBILITIES** + Intake operational...3 - 5 years of experience in a Business Analyst or Business Process Analyst role or… more
- CareFirst (Baltimore, MD)
- … Analytics team is hiring a lead data analyst with deep experience in risk adjustment . This person will support the Director of Risk Adjustment ... & Qualifications** **PURPOSE:** The main purpose of a data analyst is to find meaning in data as a... by monitoring and reporting on risk adjustment KPIs, delivering insights for prospective and retrospective … more
- Molina Healthcare (Grand Island, NE)
- …DESCRIPTION** **Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk ... identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions. + Analyze… more
- Molina Healthcare (Madison, WI)
- …Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing ... queries within project management tools like Azure DevOps. + Risk Adjustment experience and some familiarity with...support for finance, pricing and actuarial functions. + Healthcare Analyst I experience desired. + PowerBI, Excel, Power Pivot,… more
- Amazon (Seattle, WA)
- …predictive modeling in healthcare - Strong understanding of value-based care models and risk adjustment - Proven track record of translating analysis into ... Analyst II on the Amazon One Medical At- Risk team, you will be the data insights engine...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
- New York State Civil Service (Albany, NY)
- …Financial Services, Department of Title Virtual Currency Senior Blockchain Analytics Analyst (Financial Services Specialist 2 (Financial Crimes Risk ), SG-23) ... seeking candidates for the position of Virtual Currency Senior Blockchain Analytics Analyst , (Financial Services Specialist 2 (Financial Crimes Risk )) in Virtual… more
- Amazon (Arlington, VA)
- …cloud services company on Earth! Amazon Web Services is looking for a Governance, Risk , and Compliance (GRC) Senior Analyst to support third-party risk ... talented people who want to help. You'll join a diverse team of Risk Intelligence analysts and technical Program Managers. You'll collaborate with people across AWS… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency Financial Services, Department of Title Surveillance Operations Analyst (Financial Services Specialist 2 ( Risk ), SG-23) Occupational Category ... the stability of the global financial system.The Financial Services Specialist 2 ( Risk ) will be responsible for designing and overseeing the architecture that… more