- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Manager plays a critical role in the development and execution of the corporate risk ... the end to end strategy by applying improvements and driving cost-effective risk adjustment actions across all organizational populations and products.… more
- LA Care Health Plan (Los Angeles, CA)
- …the data processing, reporting, and analytics required to support the Risk Adjustment department operations Chief Architect for reporting and analytics ... to address business objectives. Provide recommendations to senior leadership based on analytics outcome. Knowledge of risk adjustment processes for multiple… more
- Molina Healthcare (St. Petersburg, FL)
- … Manager - Provider Engagement** plays a key role in driving risk adjustment and quality performance outcomes through effective program management, ... Development** + Develop, review, and update Standard Operating Procedures (SOPs) for risk adjustment and quality program workflows. + Maintain accurate,… more
- Ankura (Los Angeles, CA)
- …deliver work and seeks to gain additional opportunities for development in a variety of risk adjustment related areas. Qualifications: + Certified in Risk ... Coding (CRC) with at least five (5) recent years of experience in HCC/ Risk Adjustment and/or RADV Audit Methodology + Associate's or Bachelor's degree… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to blue. Position Summary: This role will provide analytical support to the Risk Adjustment Operations team. We're seeking a detail-oriented, curious, and ... throughout program cycles. + Manage data requirements for different Risk Adjustment activities such as in-home health...and in written format. + Work closely with the Manager and broader analytics team to collaborate… more
- PNC (Pittsburgh, PA)
- …our Model Risk Management team at PNC. The position reports to the Senior Validation Manager for Market Risk and Counterparty Risk Models and is part of ... have an opportunity to contribute to the company's success. As a Quantitative Analytics and Modeling Consultant Senior Validator within PNC's Model Risk … more
- Bristol Myers Squibb (Princeton, NJ)
- …work and in their personal lives. Read more: careers.bms.com/working-with-us . The Senior Manager , Business Development Analytics is a critical member of the BD ... and Strategy Analytics team. The Senior Manager serves as...have a strong background in statistics, forecasting, decision analysis, risk assessment, as well as prior experience working in… more
- Molina Healthcare (Albany, NY)
- …SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS ... **Job Description** **Job Summary** The Risk & Quality Performance Manager position...engine activity, risk adjustment targeting and reporting systems *… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency Financial Services, Department of Title Senior Manager , Data Architecture (Financial Services Specialist 4 ( Risk ), SG-27) Occupational Category ... various portfolios at the entity level. The individual will collaborate closely with the Risk Data & Analytics team to supply surveillance data for in-depth… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency Financial Services, Department of Title Financial Crimes Risk Manager (Director Financial Services Programs 1, SG-31) Occupational Category ... of Financial Services is seeking candidates for the position of Financial Crime Risk Manager , (Director Financial Services Programs 1), in Virtual Currency.… more
- Point32Health (MA)
- …care claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment . In-depth health care reimbursement and managed care business ... . **Job Summary** Working under the direction of the Director or Senior Manager , the Senior Network Performance Analyst will be part of a team responsible… more
- Bristol Myers Squibb (Devens, MA)
- …personal lives. Read more: careers.bms.com/working-with-us . **Position Summary** The Senior Manager , Operational Risk Management will be responsible to enhance ... out of IT systems supporting QRM processes and data analytics . + Support process monitoring/adoption and GxP risk...in their roles. Applicants can request a reasonable workplace accommodation/ adjustment prior to accepting a job offer. If you… more
- Amazon (Dallas, TX)
- …fast, think big, and can balance robust protection with seamless seller experience. The Risk Manager role offers an exciting opportunity to shape the future of ... strategic recommendations. A day in the life As a Risk Manager in Catalog Authorization, you'll protect...designs and implements innovative solutions using technology and data analytics to prevent abuse and maintain catalog quality. We… more
- New York State Civil Service (Albany, NY)
- …No Agency Financial Services, Department of Title Virtual Currency Financial Crimes Risk Associate (Financial Services Specialist 4 (Financial Crime Risk )), ... is seeking candidates for the position of Virtual Currency Financial Crimes Risk Associate, (Financial Services Specialist 4, (Financial Crime Risk )), in… more
- New York State Civil Service (Albany, NY)
- …and Counterparty Managero Market, Liquidity and Asset Liability Management Risk Manager * Project Management Institute: Portfolio Management ... tasked with optimizing database performance, ensuring scalability, and enabling advanced analytics and reporting to support entity risk management functions.This… more
- AdventHealth (Maitland, FL)
- …+ Epic HB Certification Required 6 years experience performing data, financial and/or risk analytics in a healthcare environment Required 4 years of managerial ... in understanding professional and facility claims and managed care concepts such as risk adjustment , capitation, FFS, DRG, APG, APCs and other payment mechanisms… more
- RELX INC (Alpharetta, GA)
- …technology and analytics to assist them in evaluating and predicting risk and enhancing operational efficiency. Our insurance risk solutions help drive ... Insurance Risk Solutions (https:// risk .lexisnexis.com/insurance) About our Team: LexisNexis Risk Solutions is seeking a marketing manager to join our… more
- United Airlines (Chicago, IL)
- …systemic root causes and facilitating strategic adjustments to enhance business processes and risk management. Additionally, the Senior Manager - IT and Cyber ... and successful by meeting our financial goals. **Job overview and responsibilities** The Senior Manager - IT and Cyber Audit will direct and manage a team of… more
- RELX INC (Alpharetta, GA)
- …technology and analytics to assist them in evaluating and predicting risk and enhancing operational efficiency. Our insurance risk solutions help drive ... About the Business LexisNexis Risk Solutions is the essential partner in the...are looking for a strategic and technically proficient Product Manager to support the infrastructure and connectivity initiatives that… more
- Bristol Myers Squibb (Devens, MA)
- …. **Position Summary** Reporting to the Director, Inspection Readiness, the Snr. Manager , Inspection Readiness plays a critical role in advancing the organization's ... inspection readiness program. This position leverages data analytics , regulatory trends, and quality insights to proactively identify and mitigate risks, inform… more
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