• Risk Adjustment Analyst

    Molina Healthcare (GA)
    **Job Description** **Job Summary** The Analyst , Risk Adjustment -Predictive Analytics role will support Molina's Risk Adjustment Predictive Analytics ... support Molina's Prospective and Retrospective Interventions. **Knowledge/Skills/Abilities** + Assist Risk Adjustment Data Analytics Leaders in Prospective and… more
    Molina Healthcare (07/31/25)
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  • Enterprise Risk Adjustment

    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
    LA Care Health Plan (07/11/25)
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  • Risk Adjustment Analyst

    Martin's Point Health Care (Portland, ME)
    …has been certified as a "Great Place to Work" since 2015. Position Summary The Risk Adjustment Analyst provides analytic, technical, and decision support to ... accurate, timely, and consistent information enabling informed decisions related to risk adjustment activities. The Analyst provides subject matter expertise… more
    Martin's Point Health Care (07/12/25)
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  • Risk Adjustment Actuarial…

    Elevance Health (Louisville, KY)
    ** 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
    Elevance Health (07/30/25)
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  • Risk Adjustment Business…

    Commonwealth Care Alliance (Boston, MA)
    …in other states will not be considered at this time._** Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and ... transformation methodology, and will play an essential role in driving Risk Adjustment (RA) Program performance. Supervision Exercised: * No, this position does… more
    Commonwealth Care Alliance (05/23/25)
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  • Actuarial Analyst (Medicaid Risk

    Molina Healthcare (UT)
    …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 (08/01/25)
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  • Senior Actuarial Analyst (Medicare…

    Molina Healthcare (Des Moines, IA)
    **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 (07/25/25)
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  • Senior Analyst , Healthcare Analytics…

    Molina Healthcare (Roswell, NM)
    …role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling ... complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare...support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience… more
    Molina Healthcare (07/17/25)
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  • Medicare Advantage Risk Adjustment

    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: $76,200 -… more
    UCLA Health (06/11/25)
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  • Senior, Compliance Risk Adjustment

    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
    Centene Corporation (07/31/25)
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  • Quality Review and Audit Senior Analyst

    The Cigna Group (Bloomfield, CT)
    …goals. The Quality Review and Audit Senior Analyst position recognizes experience in Risk Adjustment Data Validation audits (RADV), Risk Adjustment ... _Responsible for coordination and implementation of daily processes related to IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data… more
    The Cigna Group (07/31/25)
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  • Individual & Family Plans (IFP) Quality Review…

    The Cigna Group (Bloomfield, CT)
    Job Summary: The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates ... and any additional applicable rule set. * Utilize HHS' Risk Adjustment Model to confirm accuracy of...needed. Education & Experience: The Quality Review & Audit Analyst will have a high school diploma and **at… more
    The Cigna Group (08/01/25)
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  • Risk Adjustment Strategies…

    LA Care Health Plan (Los Angeles, CA)
    Risk Adjustment Strategies and Initiatives Analytics Program Manager II Job Category: Accounting/Finance Department: Risk Adjustment Strategies & ... net required to achieve that purpose. Job Summary The Risk Adjustment Strategies and Initiatives Analytics Program...cross-functional business partners. The Program Manager II engages the analyst team to continue to support, test and upgrade… more
    LA Care Health Plan (08/01/25)
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  • Manager Risk Adjustment Analytics

    Corewell Health (Grand Rapids, MI)
    …Some states are not eligible for remote work (CA and NY). Positioned in the Risk Adjustment Department, the Manager, Risk Adjustment Analytics will ... be responsible for leading the Risk Adjustment Analytics team and supporting the goals and objectives...in data analysis and reporting, preferably as a business analyst in the health insurance industry + 5 years… more
    Corewell Health (07/24/25)
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  • Sr. Risk Analyst , Cargo Claims

    Amazon (New York, NY)
    … Management & Claims team is seeking a highly skilled and detail-oriented Senior Risk Analyst with a background in logistics, supply chain, and data analytics. ... risk management in transportation. As a Senior Risk Analyst , you will partner with our...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
    Amazon (06/05/25)
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  • Senior 3rd Party Risk Analyst

    RELX INC (Atlanta, GA)
    Senior Third Party Risk Analyst Are you passionate about identifying and managing third-party risks that could impact business continuity, security, or ... compliance? About the role , the Senior 3rd Party Risk Analyst will analyze risks and help...a disability or other need that requires accommodation or adjustment , please let us know by completing our Applicant… more
    RELX INC (07/03/25)
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  • Surveillance Operations Analyst (Financial…

    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 ... assigned. Minimum Qualifications Preferred Qualifications* CFA Institute: Chartered Financial Analyst * Professional Risk Managers' International Association certifications:… more
    New York State Civil Service (05/31/25)
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  • Senior Third-Party Risk & Compliance…

    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
    Amazon (05/14/25)
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  • Sr. Risk Analyst , Buyer Risk

    Amazon (Seattle, WA)
    …processes that minimize risk and maximize trust in Amazon.com. As a Sr. Risk Analyst in BRP, you will be responsible for analyzing terabytes of data ... new and emerging fraud threats? Our mission in Buyer Risk Prevention (BRP) is to make Amazon.com the safest...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
    Amazon (07/25/25)
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  • Risk Analyst II, Payment Risk

    Amazon (San Diego, CA)
    …operational processes that minimize risk and maximize trust in Amazon.com. As a Risk Analyst in BRP, you will be responsible for analyzing terabytes of data ... new and emerging fraud threats? Our mission in Buyer Risk Prevention (BRP) is to make Amazon.com the safest...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
    Amazon (07/29/25)
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