• Manager of Quality - Risk Adjustment

    HCA Healthcare (Campbell, CA)
    preferred + Minimum 5 years in management position leading Quality and Risk Adjustment programs preferred + Licensure: CPC, CRC and CPQH required; LVN or RN ... like family! Jump-start your career as a(an) Manager of Quality - Risk Adjustment Programs today with HCA Healthcare. **Benefits** HCA Healthcare, offers a total… more
    HCA Healthcare (02/22/25)
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  • Risk Adjustment Coding Specialist (Remote…

    CDPHP (Albany, NY)
    …CPC certification within one year of employment is required. + CRC (Certified Risk Adjustment Coder) credential preferred . + Minimum one (1) year of experience ... to be a part of that experience. The Risk Adjustment Coding Specialist will be responsible for the chart...+ High school diploma or GED required. Associates degree preferred . + CCS/CCS-P (Certified Coding Specialist) or CPC/CPC-A (Certified… more
    CDPHP (04/07/25)
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  • Vocational Rehabilitation Counselor (Blind) (35…

    State of Connecticut, Department of Administrative Services (Bridgeport, CT)
    …rehabilitation counseling, job placement of individuals with disabilities or vocational adjustment counseling. PREFERRED QUALIFICATIONS + Experience in career ... the request and discretion of the hiring agency. + Preferred Shift/Location: Select all location(s) and shift(s) you are...and visually impaired on issues of personal and vocational adjustment . EXAMPLES OF DUTIES + Interviews applicants who are… more
    State of Connecticut, Department of Administrative Services (04/18/25)
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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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  • Sr. Risk & Quality Performance Manager (Remote)

    Molina Healthcare (Columbus, OH)
    …NPIs, TINs, etc. * History of success in roles impacting both Risk Adjustment and HEDIS ** PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** PMP, Six Sigma Green ... ABILITIES:** * 4+ years of program and/or project management experience in risk adjustment and/or quality * 4+ years of experience supporting HEDIS engine activity,… more
    Molina Healthcare (03/04/25)
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  • Risk Adjustment Coding Manager

    CareOregon (Portland, OR)
    Job Title Risk Adjustment Coding Manager Requisition # 24887 Exemption Status Exempt Management Level Manager Direct Reports Coding Auditors Manager Title Director, ... Risk Adjustment Pay and Benefits Estimated hiring range $109,500 -...Certified Documentation Expert Inpatient or Outpatient (CDEI or CDEO) Preferred + Minimum 2 years' experience in a supervisory… more
    CareOregon (04/10/25)
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  • Community Adjustment Support Staff

    Indy Gov (Indianapolis, IN)
    Community Adjustment Support Staff Print (https://www.governmentjobs.com/careers/indianapolis/jobs/newprint/4892326)  Community Adjustment Support Staff Salary ... 11:59 PM Eastern + Description + Benefits Position Summary The Community Adjustment Support Staff's primary responsibility is to provide administrative support for… more
    Indy Gov (04/03/25)
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  • Sr Mgr,Bus Consultant (IC)

    CVS Health (Columbus, OH)
    …discussions -Excellent communication, interpersonal, and presentation skills -Risk Adjustment HCC experience ** Preferred qualifications:** Medicare Advantage, ... data for multiple providers at market level to gauge risk adjustment improvement efforts. -Knowledge of payer submission sources **Required Qualifications** :… more
    CVS Health (04/26/25)
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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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  • Senior Business Analyst - Risk Adjustment

    CVS Health (Harrisburg, PA)
    …Summary** + Provide evaluation of vendor outcomes used for At-Time-of-Care Risk Adjustment solutions + Provide data analytic and evaluation support as assigned + ... will play a key collaborative role in supporting the organization's risk adjustment strategies and operations through advanced data analysis. This position involves… more
    CVS Health (04/24/25)
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  • Medicare Risk Adjustment , Manager…

    CVS Health (Montgomery, AL)
    …work in fast paced environment * Excellent stakeholder relationship management skills ** Preferred Qualifications** * 7+ years of risk adjustment , clinical ... and every day. **Position Summary** As the Manager, Risk Adjustment will be responsible for leading Risk Adjustment... Adjustment will be responsible for leading Risk Adjustment for the Southeast Region, specifically in GA/Gulf States.… more
    CVS Health (03/30/25)
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  • Lead Data Analyst (Remote) - Quality, STARS & Risk…

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Quality, Stars, and Risk Adjustment Analytics team is hiring a lead data analyst with deep experience in risk ... adjustment . This person will support the Director of Risk Adjustment by monitoring and reporting on risk adjustment KPIs, delivering insights for prospective… more
    CareFirst (03/27/25)
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  • Sr Spc, Provider Engagement (Quality and Risk…

    Molina Healthcare (Columbus, OH)
    …Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures the core set ... Health Plan have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to improve performance through… more
    Molina Healthcare (04/11/25)
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  • Manager Strategic Risk Adjustment Programs

    Highmark Health (Columbus, OH)
    …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 (03/06/25)
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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 Trainer

    Datavant (Columbus, OH)
    …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 (04/28/25)
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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 (02/19/25)
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  • Manager, Risk Adjustment Analytics

    Datavant (Columbus, OH)
    …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 (04/17/25)
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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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  • Manager Risk Adjustment Operations

    Premera Blue Cross (Mountlake Terrace, WA)
    …. Are you an experienced leader with a strong background in Risk Adjustment Operations? We invite you to join our team as the **Manager of ... Risk Adjustment Operations** , where you will lead our core...projects with inter-related Systems, Process and Business requirements **(Required)** Preferred Qualifications: + One (1) year supervisory experience +… more
    Premera Blue Cross (04/11/25)
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