• Risk Adjustment Business Analyst

    Commonwealth Care Alliance (Boston, MA)
    …from management. * Working knowledge of the provider-based healthcare industry and Risk Adjustment preferred . Required Language (must have): * English EEO is The ... 011260 CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs,… more
    Commonwealth Care Alliance (05/23/25)
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  • Risk Adjustment Analyst

    Fallon Health (Worcester, MA)
    …the provider-based healthcare industry, claims processing, provider billing or Risk Adjustment strongly preferred + Familiarity with MassHealth/Medicaid a plus ... and LinkedIn. **Brief Summary of Purpose** : The Risk Adjustment Analyst (RAA) will be a SME for the...(RAA) will be a SME for the MassHealth risk adjustment model(s) and related data submission requirements. This role… more
    Fallon Health (06/09/25)
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  • Consulting Actuary - Medicare Risk…

    BlueCross BlueShield of North Carolina (NC)
    …of relevant actuarial experience. **Bonus Points** + Experience in Medicare Advantage Risk Adjustment highly preferred **What You'll Get** + The opportunity to ... work at the cutting edge of health care delivery with a team that's deeply invested in the community. + Work-life balance, flexibility, and the autonomy to do great work. + Medical, dental, and vision coverage along with numerous health and wellness programs.… more
    BlueCross BlueShield of North Carolina (05/24/25)
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  • Consulting Actuary - ACA Risk Adjustment

    BlueCross BlueShield of North Carolina (NC)
    …years of relevant actuarial experience. **Bonus Points** + Experience in ACA Risk Adjustment Knowledge highly preferred **What You'll Get** + The opportunity to ... work at the cutting edge of health care delivery with a team that's deeply invested in the community. + Work-life balance, flexibility, and the autonomy to do great work. + Medical, dental, and vision coverage along with numerous health and wellness programs.… more
    BlueCross BlueShield of North Carolina (06/05/25)
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  • Risk Adjustment Specialist (Clinical)

    Centene Corporation (Harrisburg, PA)
    …required. Bachelor's degree in nursing and experience in managed care industry preferred . Risk adjustment and Microsoft Excel experience preferred . ... of Pennsylvania **Position Purpose:** Support the development and maintenance of Risk Adjustment related programs and reporting. Aid in working with Risk … more
    Centene Corporation (06/04/25)
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  • Risk Adjustmt Coder Educator / Clinical…

    Hartford HealthCare (Hartford, CT)
    …strongly desired. * Experience with the nuances of diagnosis coding and risk adjustment programs preferred * Progressively responsible role with leadership * ... - Physician (CCS-P) or Certified Coding Specialist (CCS) Certified Risk Adjustment Coder (CRC) preferred (required within 6 months of hire) _We take great care… more
    Hartford HealthCare (06/12/25)
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  • Director, Risk Adjustment

    Banner Health (AZ)
    …systems, claims processing and provider engagement strategies related to risk adjustment . Additional related education and/or experience preferred . **EEO ... **Department Name:** Risk Adjustment **Work Shift:** Day **Job Category:** General Operations...background in managed care, value-based care, and regulatory compliance. PREFERRED QUALIFICATIONS Master's degree preferred . Knowledge of… more
    Banner Health (06/15/25)
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  • HIM Audit and Education Specialist

    Hartford HealthCare (Farmington, CT)
    …Hartford Healthcare o Experience with the nuances of diagnosis coding and risk adjustment programs preferred ** o Experience working in an educational/ training ... specialist will support documentation practices that comply with CMS risk adjustment program requirements and ICD 10 coding guidelines. Reporting to Manager… more
    Hartford HealthCare (04/24/25)
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  • Analyst, Data Analytics

    Convey Health Solutions (Chicago, IL)
    …Familiarity with healthcare payer/provider claims, clinical, or quality data. + Risk Adjustment experience is preferred . OTHER DUTIES AND RESPONSIBILITIES + ... to accelerate analytic insights and new feature enhancements to Pareto's risk adjustment solution suite. Additionally, the ability to understand / contribute to… more
    Convey Health Solutions (05/30/25)
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  • Senior Healthcare Decision Support Analyst remote…

    Trinity Health (Columbus, OH)
    …established timelines. + Knowledge of health plan operations (claims, revenue, or risk adjustment ) preferred . + Advanced MS Excel skills. + Experience working ... **Experience** : Five or more years' experience in a finance setting (healthcare preferred ) in one of the following areas: decision support, data analytics, or… more
    Trinity Health (05/14/25)
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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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  • 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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  • 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 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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  • 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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  • 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 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 ... you will bring to the table: + 2+ years prior training experience, preferred + A strong knowledge base of medical terminology, medical abbreviations, pharmacology… more
    Datavant (05/07/25)
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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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  • 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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  • 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- based coders within the Population Health Services Organization… more
    Dignity Health (05/15/25)
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