• Director, Risk Adjustment

    Banner Health (AZ)
    **Department Name:** Risk Adjustment **Work Shift:** Day **Job Category:** General Operations **Estimated Pay Range:** $53.63 - $89.38 / hour, based on location, ... remote and hybrid opportunities. As the Director of Risk Adjustment , you will lead a dynamic team focused on...provider-facing staff. You'll also work closely with other Risk Adjustment teams within the department to align strategies and… more
    Banner Health (06/15/25)
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  • Risk Adjustment Coding Specialist-Excellus…

    Trinity Health (Syracuse, NY)
    **Employment Type:** Full time **Shift:** **Description:** Rist Adjustment experience. Ability to conduct Education if needed. Auditing Experience Posting POSITION ... PURPOSE: The Risk Adjustment Coding Specialist works in a team environment and...and training will be conducted per Excellus payer risk adjustment coding guidelines and required of all PCPs within… more
    Trinity Health (05/29/25)
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  • Risk Adjustment Coding Coordinator I/II

    Excellus BlueCross BlueShield (Buffalo, NY)
    …you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making and ... to ensure accurate diagnosis coding. This position is responsible for risk adjustment coding and quality assurance validation for the following programs, including… more
    Excellus BlueCross BlueShield (05/20/25)
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  • Product Manager, Risk Adjustment Analytics…

    Datavant (Lincoln, NE)
    …our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy and execution of ... analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable,...+ Define and own the product vision for risk adjustment analytics across retrospective and prospective use cases. +… more
    Datavant (06/06/25)
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  • Risk Adjustment Specialist (Clinical)

    Centene Corporation (Harrisburg, PA)
    …of Pennsylvania **Position Purpose:** Support the development and maintenance of Risk Adjustment related programs and reporting. Aid in working with Risk ... Adjustment vendors for programs within all lines of business....Aid in the development and support of company-wide Risk Adjustment initiatives within all product lines and assist in… more
    Centene Corporation (06/04/25)
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  • HCC Risk Adjustment Coder

    MedKoder (Mandeville, LA)
    …schedule. Description: MedKoder, LLC is seeking a remote Professional HCC Risk Adjustment Coder who will apply both technical and specialized expertise to help ... while identifying opportunities for increased financial success. The HCC Risk Adjustment Coder provides coding services to health systems and insurance plans… more
    MedKoder (04/15/25)
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  • Risk Adjustment Business Analyst

    Commonwealth Care Alliance (Boston, MA)
    011260 CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs, ... transformation methodology, and will play an essential role in driving Risk Adjustment (RA) Program performance. Supervision Exercised: * No, this position does not… more
    Commonwealth Care Alliance (05/23/25)
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  • Professional, Risk Adjustment Analyst

    MVP Health Care (Schenectady, NY)
    Professional, Risk Adjustment Analyst Headquarters Office, 625 State Street, Schenectady, New York, United States of America * Rochester Office, 20 S. Clinton Ave, ... and continuous improvement. To achieve this, we're looking for a **Professional, Risk Adjustment Analyst** to join #TeamMVP. This is the opportunity for you if you… more
    MVP Health Care (05/21/25)
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  • Manager, Risk Adjustment Analytics

    Datavant (Little Rock, AR)
    …our bold vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping into a role on the Business Analytics ... and management of workloads, communication with stakeholders, and the risk adjustment subject matter expertise necessary to be operating proactively vs reactively.… more
    Datavant (06/12/25)
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  • Manager Strategic Risk Adjustment Programs

    Highmark Health (Des Moines, IA)
    …job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its ... and achieve strategic objectives relative to new and existing Risk Adjustment Programs. Supports other key objectives designed to build/strengthen patient care… more
    Highmark Health (06/05/25)
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  • Risk Adjustment Compliance Professional 2

    Humana (Boise, ID)
    …our caring community and help us put health first** The Risk Adjustment Compliance Professional 2 supports the organization's adherence to governmental and ... contractual requirements, with a focus on risk adjustment operations. The role involves varied work assignments that require analysis, interpretation or regulatory… more
    Humana (05/22/25)
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  • Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment coding and ... documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan. You will: + Conduct medical record audits for… more
    UCLA Health (05/16/25)
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  • Risk Adjustment Coding and Training…

    Dignity Health (Bakersfield, CA)
    **Responsibilities** This position is remote.** **Position Summary:** The Risk Adjustment Coding Training Specialist develops and executes comprehensive training ... programs focused on value-based risk adjustment coding. This role ensures that clinicians and value-...standards. Travels to provider offices when necessary. The Risk Adjustment Coding and Training Specialist is responsible for developing… more
    Dignity Health (05/15/25)
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  • Risk Adjustment Trainer

    Datavant (Trenton, NJ)
    …experiences to realize our bold vision for healthcare. We're looking for a Risk Adjustment Trainer to help us uplevel our Risk Adjustment Coding Department ... and models + Experience with coding Medicare, Commercial and Medicaid risk adjustment charts + Understanding of Medicare, Commercial and Medicaid risk adjustment more
    Datavant (05/07/25)
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  • VP Risk Adjustment Accuracy Management

    Highmark Health (Pittsburgh, PA)
    …and Management: + Provide strategic leadership and management for the Risk Adjustment Accuracy Management Department. + Develop and oversee programs to ensure ... and adapt infrastructure (processes, systems, talent) to support an effective risk adjustment program as CMS/HHS/DPW evolves the models and guidance. + Accountable… more
    Highmark Health (04/30/25)
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  • Director of Actuarial and Risk Adjustment

    Marshfield Clinic (Marshfield, WI)
    …in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** 682891378 SHP-Actuarial **Scheduled Weekly Hours:** 40 **Employee ... of America) **Job Description:** **JOB SUMMARY** The Director of Actuarial & Risk Adjustment Services is a key leader for commercial and government program actuarial… more
    Marshfield Clinic (03/31/25)
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  • Risk Adjustment Analyst

    Fallon Health (Worcester, MA)
    …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 ... improve reporting and product performance. The RAA will represent the Risk Adjustment & Analytics team, participating in corporate project workgroups and team… more
    Fallon Health (06/09/25)
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  • Manager Risk Adjustment Vendor Management

    Excellus BlueCross BlueShield (Rochester, NY)
    …project. This position is accountable for the performance of vendors within Risk Adjustment . Leads in the identification and selection of vendors by directing the ... ensure realization of the expected value from the relationship. Executes risk adjustment vendor contracts and contract renewal negotiations. The incumbent in this… more
    Excellus BlueCross BlueShield (05/24/25)
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  • Senior Actuarial Analyst (Risk Adjustment

    Molina Healthcare (Ann Arbor, MI)
    …for being the SME (Subject Matter Expert) for Medicaid risk adjustment program valuation. Maintain SQL/Databricks model, estimate valuations, and analyze results. ... to identify risks. **KNOWLEDGE/SKILLS/ABILITIES** + Build and maintain risk adjustment valuation models (SQL/Databricks). + Collaborate with Actuarial & Operations… more
    Molina Healthcare (06/11/25)
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  • Medicare Advantage Risk Adjustment Business…

    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 department ... 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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