- University of Utah Health (Murray, UT)
- …and trust that are integral to our mission. EO/AA_ + Risk Adjustment Analyst position provides support for our health plan's risk adjustment ... Science, Applied Math, or related field. + 2+ years of experience in risk adjustment analytics within a health plan or healthcare organization. + Proficiency… more
- LA Care Health Plan (Los Angeles, CA)
- Enterprise Risk Adjustment Analyst III Job Category: Accounting/Finance Department: Risk Adjustment Strategies & Initiatives Location: Los Angeles, ... required to achieve that purpose. Job Summary The Enterprise Risk Adjustment Analyst III provides...adjustment changes that regulatory bodies pass on to health plans as it relates to reimbursement reporting requirements.… 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 ... an accommodation is granted as required by law._ The ** Risk Adjustment Actuarial Analyst II...and New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… 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... results and quality, accuracy and identification of member health conditions. Update, create and maintain business process and… more
- MVP Health Care (Rochester, NY)
- At MVP Health Care, we're on a mission to create a...improvement. To achieve this, we're looking for a **Sr. Risk Adjustment Analyst ** to join #TeamMVP. ... well-being + An opportunity to shape the future of health care by joining a team recognized as a...while achieving desired results required + Knowledge of CMS risk adjustment and reinsurance payment processes and… 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...Attend meetings with Accountable Care Organiztions (ACOs) that Fallon Health shares risk with + Routinely run… 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
- 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 ... cycles. + Collaborate closely with Decision Support Services and Health Outcome & Analysis teams to transition ongoing reports...a key departmental resource for application use related to risk adjustment coding guidelines and gap closure… 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
- 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 ... for our 28 million members. Centene is transforming the health of our communities, one person at a time....compliance issues. Facilitates and leads external audits related to Risk Adjustment processes. Ensures visibility by way… 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 ... Auditor/ Analyst is an integral part of the Risk Adjustment Department and is responsible for...to the appropriateness of coding, clinical care, documentation, and health plan business rules. Accurately review the assigned HCC… 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 ... + Experience developing queries within project management tools like Azure DevOps. + Risk Adjustment experience and some familiarity with Power BI level report… 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 ... part of our caring community and help us put health first** The Financial Analytics Professional manages data to...Medicare regulations and payment models, monitors and reports on risk adjustment data submissions, and supports operations.… 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
- 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 ... responsible for empowering consumers and protecting them from financial harm; ensuring the health of the entities we regulate; driving economic growth in New York… more
- Molina Healthcare (AZ)
- …Azure, AWS, or Hadoop + 3-5 years of experience in Analysis related to HEDIS and/or Risk Adjustment + 3-5 years of experience in working with complex data to ... **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and… more
- Fair Haven Community Health Care (New Haven, CT)
- …and/or claims data (Medicaid/Medicare/commercial). + Working knowledge of eCQMs, UDS, HEDIS, risk adjustment /HCCs, and value-based care measures. + Ability to ... Data Analytics Professional Certificate, Microsoft Certified: Power BI Data Analyst Associate, AHIMA Certified Health Data ...Power BI Data Analyst Associate, AHIMA Certified Health Data Analyst , Coursera Data Analytics and/or… more
- Providence (WA)
- …the Data Analytics department. The Principal must maintain an understanding of the changing health care trends and Risk Adjustment regulations and the impact ... **Description** **Providence Health Plan** caregivers are not simply valued -...retain the best people, we must empower them. The Risk Adjustment Analytics Principal acts as the… more
- CVS Health (IN)
- …the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical ... At CVS Health , we're building a world of health...all body systems + Understand the audit process for risk adjustment models. + Identify and communicate… more