- Elevance Health (Woodbridge, NJ)
- **Medicare Risk Adjustment Advanced Analytics Analyst** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per week,** ... unless an accommodation is granted as required by law._ The **Medicare Risk Adjustment Advanced Analytics Analyst** is responsible for employing advanced… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Risk Adjustment Auditor Educator** -St. Peter's Health Partners - Full-time - Remote ... **POSITION PURPOSE:** A Risk Adjustment Auditor Educator is responsible for ensuring accurate coding and documentation in alignment with risk adjustment … more
- Corewell Health (Grand Rapids, MI)
- …Some states are not eligible for remote work (CA and NY). Positioned in the Risk Adjustment Department, the Manager, Risk Adjustment Analytics will ... be responsible for leading the Risk Adjustment Analytics team and supporting the goals and objectives...team and supporting the goals and objectives of the risk adjustment department through leading all data… more
- Corewell Health (Grand Rapids, MI)
- Job Summary The Director Risk Adjustment Prospective Operations & Risk Mitigation is the thought leader role responsible for ensuring the complete and ... role is a key strategic leader who initiates, develops and executes/implements the multi-product risk adjustment strategy set by the executive leaders of Risk… more
- Tufts Medicine (Burlington, MA)
- …the greater Boston region. **Job Overview** Under the director of the Director, Risk Adjustment Operations, performs accurate and timely reviews and validations ... both established coding standards as well as CMS and Commercial Risk Adjustment guidelines. This position has extensive knowledge of overall ICD-10-CM coding… more
- LA Care Health Plan (Los Angeles, CA)
- Enterprise Risk Adjustment Analyst III Job Category: Accounting/Finance Department: Risk Adjustment Strategies & Initiatives Location: Los Angeles, CA, ... support the safety net required to achieve that purpose. Job Summary The Enterprise Risk Adjustment Analyst III provides a key leadership role in the Risk … more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …your true colors to blue. Under the direction of the Senior Director of Medicare Risk Adjustment and Analytics, the Associate Director of Risk Adjustment ... for the Medicare and Merged Market segments. The Associate Director of Risk Adjustment Data and Analytics will oversee the reporting, analytics and management of… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …to help us transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior Director of ... Medicare Risk Adjustment and Analytics. This role will manage the process of developing and maintaining the risk adjustment strategic plan. This position… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Director, Risk Adjustment oversees the outcomes and operations of risk adjustment across the organization ... within Medicare Advantage, Medicaid & ACA markets. The Risk Adjustment Director is responsible for strategic direction, leadership, establishing and maturing key… more
- Blue KC (Kansas City, MO)
- …**Employee discount program** **Job Description Summary:** The Director, Government Programs Risk Adjustment & Audit assumes overall leadership of the ... risk adjusted revenue optimization strategy and oversight of Government Programs Risk Adjustment programs. **Job Description** + Interface with Blue KC… more
- Trinity Health (Syracuse, NY)
- …to conduct Education if needed. Auditing Experience Posting **POSITION PURPOSE:** A Risk Adjustment Auditor Educator is responsible for ensuring accurate coding ... and documentation in alignment with risk adjustment models, conducting audits with analysis of trends, and providing education to providers and coders. They work… more
- Commonwealth Care Alliance (Boston, MA)
- …the Director of Encounter Data Management within the Revenue Cycle Department, the Risk Adjustment Data Developer is responsible for the design, development, and ... of data systems and tools that support Commonwealth Care Alliance's (CCA) risk adjustment and Hierarchical Condition Category (HCC) revenue programs. This… more
- Molina Healthcare (Roswell, NM)
- …role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling ... of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare intervention program performance.… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Risk Adjustment Analyst provides analytic, technical, and decision support to the ... Risk Adjustment Team utilizing third party software as well as the data warehouse as key sources of data. The Analyst works closely with our internal customers… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote ... **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works in a team environment and is responsible for reviewing clinical documentation and coding using… more
- Elevance Health (Louisville, KY)
- **Medicare Risk Adjustment Advanced Analytics Consultant** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per ... unless an accommodation is granted as required by law._ The **Medicare Risk Adjustment Advanced Analytics Consultant** is responsible for employing advanced… more
- Marshfield Clinic (Marshfield, WI)
- …to support the most exciting missions in the world!** **Job Title:** Risk Adjustment Revenue Director (Remote/Hybrid) **Cost Center:** 682891390 SHP-Strategic ... 40 Normal (United States of America) **Job Description:** **JOB SUMMARY** The Risk Adjustment Revenue Director is a finance leader responsible for risk … more
- Centene Corporation (Tallahassee, FL)
- …from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on the ... of compliance issues. Facilitates and leads external audits related to Risk Adjustment processes. Ensures visibility by way of reporting out audit deliverables… more
- Datavant (Lincoln, NE)
- …to realize 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, and actionable analytics… more
- Highmark Health (Blue Bell, PA)
- …Development and Management: + Provide strategic leadership and management for the Risk Adjustment Accuracy Management Department. + Develop and oversee programs ... and adapt infrastructure (processes, systems, talent) to support an effective risk adjustment program as CMS/HHS/DPW evolves the models and guidance. +… more
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