- Martin's Point Health Care (Portland, ME)
- …Plan which is growing and making an impact! Apply today for immediate consideration! The Senior Risk Adjustment Analyst in our Health Plan analyzes ... the data warehouse as key sources of data. The Senior Analyst uses their extensive content knowledge...used in complex conceptual analyses for all departments within Risk Adjustment Operations + Develops systematic reporting… more
- Point32Health (Canton, MA)
- …this individual will be responsible for supporting critical data submission functions for the Risk Adjustment Department (RAD) including risk adjustment ... and timely resolution of production issues pertaining to CMS and risk adjustment data submission, including issue investigation, business requirements,… more
- CVS Health (Hartford, CT)
- …to make health care more personal, convenient and affordable. Position Summary The Medicaid Risk Adjustment Sr. Analyst will play a critical role in ... and other business needs. Reporting to the Sr. Manager of Medicaid Risk Adjustment Analytics, the Sr. Analyst will work closely with cross-functional… more
- The Cigna Group (UT)
- ** Risk Adjustment Provider Educator** **_Incumbent_** **_candidate must reside in assigned territory and have the ability to travel to the local office and ... to base salary._** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment program for assigned populations in an operational market.… 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 will...senior leadership based on analytics outcome. Knowledge of risk adjustment processes for multiple lines of… more
- Bloomberg (New York, NY)
- …regulators, clients, and other external stakeholders continue to evolve. We are looking for a Senior Risk Analyst who will develop a deep understanding of ... and be able to analyze and understand the inherent risks within our processes. The Senior Risk Analyst will be accountable to perform detailed analytics work… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Supports Risk Adjustment & Stars organization to optimize Risk Adjustment revenue and coding accuracy through ... Responsible for developing performance monitoring reports and analytics related to Risk Adjustment & Stars programs and processes. We are looking for an… more
- UCLA Health (Los Angeles, CA)
- …can do all this and more at UCLA Health. As member of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director of Risk Adjustment ... monitoring of key performance indicators to enable operational excellence within the risk adjustment department. You will be responsible for coordinating mock… more
- The Cigna Group (Memphis, TN)
- …area** **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment & Stars program for assigned populations in an ... market. The role will be accountable for assigned provider groups reaching risk adjustment and stars related annual metrics. This role will work directly with… more
- Truist (Charlotte, NC)
- …of the Market and Liquidity Risk Management (MLRM) team within the Risk Management Organization (RMO), works with the Senior Treasury Market and Liquidity ... tools and processes. Preferred Qualifications: 1. Industry certification such as Chartered Financial Analyst (CFA) or Financial Risk Manager (FRM). 2. 2-5 years… more
- AdventHealth (Maitland, FL)
- …in understanding professional and facility claims and managed care concepts such as risk adjustment , capitation, FFS, DRG, APG, APCs and other payment mechanisms ... 3 days at the office (Altamonte Springs,FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating… more
- Intermountain Health (Murray, UT)
- … Analyst -Technical- Senior is on the Encounter Data team in the Risk Adjustment department. This position will be responsible for understanding and ... and processes impacted by data and systems. The business analyst serves as the central point for interface changes...level) if they do not fully qualify for the Senior level. Unfortunately, we are not currently considering candidates… more
- RELX INC (Houston, TX)
- Senior Analyst Do you enjoy using a data-driven approach to uncover information and insights? Are you a skilled communicator? About the Business: At ICIS, our ... consulting; always willing to share experience and knowledge. About the Role: As a Senior Analyst , you will be responsible for analyzing complex datasets to… more
- Healthfirst (New York, NY)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... it needs to produce results and deliver impactful business recommendations. As a Senior Medical Economics Analyst , you'll map out and construct detailed… more
- Dow Jones (New York, NY)
- …Mansion Global, Financial News, Investor's Business Daily, Factiva, Dow Jones Risk & Compliance, Dow Jones Newswires, OPIS and Chemical Market Analytics. ... important role in year-end processes and will have direct interaction with senior -level executives. Strong data analytics and data integrity skills are necessary for… more
- Aston Carter (Princeton, NJ)
- …of Aston Carter's clients in the medical devices space is looking for an experienced Senior Financial Analyst to join the team during this crucial time. This ... historical financial data + Explore investment options and present risk and opportunities + Coordinate with the CFO (https://resources.workable.com/cfo-job-description)… more
- Providence (NM)
- …the rate development and filing efforts including competitive analysis, network analysis, risk adjustment , trend, actuarial benefit value analysis, rate adequacy ... we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Commercial Pricing who will:** + Analyze the financial performance of… more
- Bausch Health (Bridgewater, NJ)
- …improving people's lives with our health care products. As a Sr Cybersecurity Analyst , you will help secure Bausch Health infrastructure against both inside and ... standards, tools, policies, and procedures to improve security, compliance and risk management activities based on security operations findings, or security events… more
- Highmark Health (Dover, DE)
- …Healthcare-related field **Substitutions** + 6 years of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS, and/or health ... None **EXPERIENCE** **Required** + 5-10 years of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS, and/or health… more
- UCLA Health (Los Angeles, CA)
- …variety of topics, including pricing, forecasting, reserving, trend analysis, value-based care, and risk adjustment - mainly focusing on MAPD business. This will ... time management, and organizational skills * Ability to work effectively with senior staff and managers * Computer proficiency, including advanced knowledge of Excel… more