- Leap Here LLC (Des Moines, IA)
- …of Iowans. The Division of Information Technology (DOIT) seeks a Business Analyst to support service management initiatives. Experience in ITSM and familiarity with ... ITIL practices is preferred. Responsibilities of business analyst role include but are not limited to: Collaborate...framework with a focus on value delivery and swift adjustment to produce the most effective outcome. Work close… 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 ... programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Risk Adjustment **Equal Employment Opportunity ** CareFirst… 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
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and ... programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Risk Adjustment **Equal Employment Opportunity ** CareFirst… more
- Centene Corporation (Jefferson City, MO)
- …from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on the ... compliance issues. Facilitates and leads external audits related to Risk Adjustment processes. Ensures visibility by way...be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values… more
- UNC Health Care (Chapel Hill, NC)
- …the health and well-being of the unique communities we serve. Summary: The Risk Adjustment Coordinator will be responsible for analyzing and auditing medical ... payer under the value care contracts. In addition, the Risk Adjustment Coordinator will be responsible for...System, in a department that provides shared services to operations across UNC Health Care; except that, if you… more
- Humana (Louisville, KY)
- …in Medicare regulations and payment models, monitors and reports on risk adjustment data submissions, and supports operations . This role will be responsible ... hybrid based on business discretion. The MRA Finance team supports Humana's Medicare Risk Adjustment business area. The Finance team develops revenue and … more
- Centene Corporation (Jefferson City, MO)
- …the Continental United States. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment activities, including monitoring, auditing, and supports Line 1 ... complete diagnosis coding in alignment with HCCs and other risk adjustment models. Identifies and evaluates clinical...be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values… more
- Centene Corporation (Jefferson City, MO)
- …the Continental United States. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment activities, to include identifying compliance risks, auditing ... findings to business stakeholders to ensure the quality of risk adjustment data. + Ensure coding accuracy...be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values… more
- Molina Healthcare (Dayton, OH)
- …DESCRIPTION** **Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk ... sources to identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk … more
- Centene Corporation (Raleigh, NC)
- …perspective on workplace flexibility. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment including monitoring, auditing, and Line 1 oversight. ... and effectively communicates findings to stakeholders, ensuring the highest quality of risk adjustment data. Develop algorithms and models to identify high… more
- New York State Civil Service (Albany, NY)
- …No Agency Financial Services, Department of Title Surveillance Operations Analyst (Financial Services Specialist 2 ( Risk ), SG-23) Occupational Category ... to monitor risk across all supervised entities.* Oversees daily surveillance operations to identify and track risk and performance issues.* Ensures… 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 (Austin, TX)
- …services company on Earth! Amazon Web Services (AWS) is seeking a Senior Third-Party Risk Intelligence Analyst as part of its Supplier Governance team. In this ... want to help. You'll join a diverse team of Risk Intelligence analysts, security engineers, and technical Program Managers....Secret US Government security clearance. Amazon is an equal opportunity employer and does not discriminate on the basis… more
- The Cigna Group (Bloomfield, CT)
- … position recognizes experience in Risk Adjustment Data Validation audits (RADV), Risk Adjustment operations , Risk Adjustment medical record ... colleagues, and Matrix Partners. **Core Responsibilities:** + Oversight and coordination of daily operations for IFP Risk Adjustment Data Validation (RADV)… more
- Citigroup (Tampa, FL)
- The Data Governance Foundation Sr Lead Analyst is responsible for leading activities that contribute to the definition of the Enterprise Data Governance Strategy, ... and/or Data Risk and Control Framework and Data Risk ...in establishing and overseeing the operating model for the Adjustment Reduction and Data Automation program. This high-impact position… more
- The Cigna Group (Bloomfield, CT)
- …of the HHS' Risk Adjustment (RA) program and Risk Adjustment Data Validation (RADV) audits. The Senior Analyst is responsible for all aspects of ... The Quality Review & Audit Senior Analyst exhibits expertise in evaluating complex medical documentation...expertise in RA programs. * Contributes to execution of Risk Adjustment programs, and other IFP programs,… more
- RELX INC (Washington, DC)
- About the BusinessLexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Government vertical, our solutions assist government ... decisions to enhance investigations. You can learn more about LexisNexis Risk at the link below. https:// risk .lexisnexis.com/government About the TeamThe… more
- BP Americas, Inc. (Chicago, IL)
- …Trading knowledge, Trading risk controls **Legal Disclaimer:** We are an equal opportunity employer and value diversity at our company. We do not discriminate on ... **Job Family Group:** Finance Group **Job Description:** The Innovation Senior Analyst will help drive our continuous improvement and innovation program. This… 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 ... of ability to pay. Job purpose The Senior Data Analyst turns clinical, operational, and financial data into insights...and mentor analysts while collaborating closely with Clinical, Quality, Operations , Finance, and IT in support of the strategy… more
