- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …legally protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Director Risk Adjustment and Quality Analytics - Actuarial ... a difference, join us. The Impact You Will Have We are looking for a Director of Risk Adjustment and Quality Analytics to lead a team that delivers insights… more
- Providence (Portland, OR)
- …work mostly remotely in the states of WA, OR and CA. **The Role:** As the Director of Risk Adjustment and Strategic Accounts at Providence Health Plan, you ... will be the cornerstone of our strategic vision. You will oversee risk adjustment programs, spearhead provider education, and enhance engagement to support… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …any legally protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Director of Risk Adjustment Location: Hybrid | Eagan, Minnesota ... Career Area: Special Services/Product Lines The Impact You Will Have The Director of Risk Adjustment is a key leader responsible for shaping risk … more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Director , Quality and Risk Adjustment has regional oversight of the development ... that is submitted to CMS and other governmental agencies. The Director , Quality and Risk Adjustment requires an in-depth understanding of how organization… more
- HCA Healthcare (Campbell, CA)
- …alone, HCA Healthcare colleagues invested over 156,000 hours impacting our communities. As a Director of Quality and Risk Adjustment with HCA Healthcare, you ... for benefits may vary by location._** Come join our team as a Director of Quality and Risk Adjustment . We care for our communities and employees! HCA Hope… more
- Point32Health (Canton, MA)
- …with our corporate and business division goals. This position will report to the Director of Risk Adjustment Strategy, Operations and Quality Assurance. ... Point32Health (https://www.point32health.org/) . **Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible… more
- Ankura (New York, NY)
- …operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also ... of activities: + Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit, and investigation projects for clients. +… more
- Mount Sinai Health System (New York, NY)
- …adjustment with a group of practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This ... hardwiring processes to drive excellence in efficiency of care, quality and accurate risk adjustment for all populations served, especially our patients covered… more
- Molina Healthcare (MI)
- …Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment , is responsible for the implementation, monitoring, and oversight ... of all chart collection for Risk Adjustment , RADV, or Risk Adjustment -like projects, and other state specific audit projects and deliverables related to… more
- Henry Ford Health System (Troy, MI)
- …Cycle processes within value-based reimbursement models and initiatives. Reporting to the Director , Risk Adjustment and Value-Based Payment, the Program ... Manager is responsible for complex program management, strategic planning, and process improvement activities. The leader acts with a high degree of autonomy focusing on improving Revenue Cycle processes, Population Health program management, Accountable Care… more
- Avera (Sioux Falls, SD)
- …and Healthcare Effectiveness Data Information Sets (HEDIS). The Quality and Risk Adjustment Specialist will work closely with the Director of Quality and ... Risk Services, Manager of Risk Adjustment , Manager of Quality, Quality Coordinator - HEDIS, coder(s), claims staff, and primary care & specialty care… more
- Bristol Myers Squibb (Princeton, NJ)
- …and in their personal lives. Read more: careers.bms.com/working-with-us . Third-Party Risk Management (TPRM) is essential to safeguard patient safety, ensure ... Myers Squibb's reputation by proactively identifying, assessing, and mitigating risk across a complex global supplier network. We seek...a complex global supplier network. We seek an Executive Director with the vision to shape global strategy, the… more
- Basin Electric Power Cooperative (Bismarck, ND)
- Job Title: DIRECTOR /MANAGER, RISK & INSURANCE (DOE) Posting Start Date: 10/3/25 Job Description: **POSITION PURPOSE** This position is open to varying levels of ... risk of loss, planning, managing, and coordinating risk regarding the property, Director and Officer...SKILLS** + Knowledge of property and casualty insurance, claims adjustment , and risk analysis. + Proficient with… more
- Bristol Myers Squibb (New Brunswick, NJ)
- …work and in their personal lives. Read more: careers.bms.com/working-with-us . The Associate Director , RBQM - HOCT, ICN will mainly be responsible for developing the ... critical to quality (CtQ) data, processes, and vendors, demonstrating effective risk and issue management. Provide quality and compliance consultation to clinical… more
- Commonwealth of Pennsylvania (PA)
- …designs and/or conducting research in fields of personality development and adjustment , diagnosis, risk assessment, treatment and prevention of mental ... experimental designs or conducting research in fields of personality development and adjustment , diagnosis, risk assessment, treatment and prevention of mental… more
- CenterWell (Jackson, MS)
- …interrelate across the function or segment. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing ... caring community and help us put health first** The Director , Medical Coding extracts clinical information from a variety...Responsible for performance management and strategy development for PCO risk adjustment at the division and market… more
- Point32Health (ME)
- …and will work in a matrix environment collaborating with functions including risk adjustment , population health, finance, operations, actuarial, and sales. **Job ... we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Director of Contracting is responsible for contract strategy, development,… more
- US Foods (MD)
- …Join Our Community of Food People! BASIC PURPOSE As a Senior Director , Region Replenishment within US Foods, you will be pivotal in the ... organization, and driving continuous improvement within the function. As a Senior Director , Region Replenishment, you are accountable for the region's service levels… more
- AmeriHealth Caritas (Washington, DC)
- …Enrollment, Contact Center Operations, IT, Provider Configuration Management, Program Integrity, Risk Adjustment , Provider Resolution Team, Provider Appeal and ... **Job Responsibilities** The Director Operations (Healthy DC Plan) reports to the...and identify opportunities for improved profitability, health outcomes, and risk adjustment goals; directs analytical activities to… more
- AIG (Atlanta, GA)
- At AIG, we are reimagining the way we help customers to manage risk . Join us as a Complex Claims Director - Aviation to play your part in that transformation. ... position requires the adjustment of complex aircraft damage claims. The Complex Director will function as a key account contact for multiple programs across all… more
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