• 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 - $133,840 / year, 5% bonus target, full benefits.… more
    CareOregon (04/10/25)
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  • Manager of Quality - Risk Adjustment

    HCA Healthcare (Campbell, CA)
    …We care like family! Jump-start your career as a(an) Manager of Quality - Risk Adjustment Programs today with HCA Healthcare. **Benefits** HCA Healthcare, offers ... vary by location._** Come join our team as a(an) Manager of Quality - Risk Adjustment Programs. We care for our community! Just last year, HCA Healthcare and our… more
    HCA Healthcare (02/22/25)
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  • Risk Adjustment Coding…

    Trinity Health (Syracuse, NY)
    …Ability to conduct Education if needed. Auditing Experience Posting POSITION PURPOSE: The Risk Adjustment Coding Specialist works in a team environment and is ... visit. . HCC education and training will be conducted per Excellus payer risk adjustment coding guidelines and required of all PCPs within the practices of SJH.… more
    Trinity Health (04/24/25)
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  • Director for Quality and Risk

    Robert Half Accountemps (Long Beach, CA)
    Description The Director for Quality and Risk Adjustment is responsible for leading enterprise development of the Medicare Star Ratings and Enterprise Risk ... 4+ and ensure risk score accuracy and completeness in all enterprise risk adjustment activities. Development of strategy includes integrating the Star and … more
    Robert Half Accountemps (04/04/25)
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  • Medicare Risk Adjustment , Manager…

    CVS Health (Montgomery, AL)
    …And we do it all with heart, each and every day. **Position Summary** As the Manager, Risk Adjustment will be responsible for leading Risk Adjustment for ... States. This role will have responsibility in maintaining and improving risk adjustment accuracy by partnering closely with leadership from our key value-based… more
    CVS Health (03/30/25)
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  • Senior Business Analyst - Risk

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

    MedKoder (Mandeville, LA)
    …a flexible schedule. Description: MedKoder, LLC is seeking a remote Professional HCC Risk Adjustment Coder who will apply both technical and specialized ... while identifying opportunities for increased financial success. The HCC Risk Adjustment Coder provides coding services to health systems and insurance… more
    MedKoder (04/15/25)
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  • Lead Data Analyst (Remote) - Quality, STARS…

    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… more
    CareFirst (03/27/25)
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  • VP Risk Adjustment Accuracy…

    Highmark Health (Pittsburgh, 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
    Highmark Health (04/30/25)
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  • Sr Spc, Provider Engagement (Quality…

    Molina Healthcare (Miami, FL)
    …Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures ... the Health Plan have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to improve performance… more
    Molina Healthcare (04/30/25)
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  • Medicare Advantage Risk Adjustment

    UCLA Health (Los Angeles, CA)
    Description As the Medicare Advantage Risk Adjustment Performance Improvement Consultant, you will be responsible for: + Serving as a Subject Matter Expert (SME) ... for risk adjustment with contracted IPAs + Collaborating with IPAs on risk adjustment strategies to achieve health plan goals and KPIs + Presenting and… more
    UCLA Health (04/24/25)
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  • Director of Actuarial and Risk

    Marshfield Clinic (Marshfield, WI)
    …exciting missions in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** 682891378 SHP-Actuarial **Scheduled Weekly ... of America) **Job Description:** **JOB SUMMARY** The Director of Actuarial & Risk Adjustment Services is a key leader for commercial and government program… more
    Marshfield Clinic (03/31/25)
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  • Manager Strategic Risk Adjustment

    Highmark Health (St. Paul, MN)
    …This job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health ... business outcomes and achieve strategic objectives relative to new and existing Risk Adjustment Programs. Supports other key objectives designed to… more
    Highmark Health (03/06/25)
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  • Director, Quality & Risk Adjustment

    Molina Healthcare (New York, NY)
    **Job Description** **Job Summary** The Director, Quality & Risk Adjustment is responsible for leading health plan execution for Risk and Quality ensuring ... of Quality Discipline including metrics and performance standards. Working knowledge of Risk Adjustment . + Project management experience, in a managed healthcare… more
    Molina Healthcare (04/20/25)
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  • Risk Adjustment Trainer

    Datavant (Tallahassee, FL)
    …and life experiences to realize our bold vision for healthcare. We're looking for a Risk Adjustment Trainer to help us uplevel our Risk Adjustment ... of HCC mapping and models + Experience with coding Medicare, Commercial and Medicaid risk adjustment charts + Understanding of Medicare, Commercial and Medicaid … more
    Datavant (04/28/25)
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  • Manager, Risk Adjustment Analytics

    Datavant (Columbus, OH)
    …to realize our bold vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping into a role on the ... proper planning and management of workloads, communication with stakeholders, and the risk adjustment subject matter expertise necessary to be operating… more
    Datavant (04/17/25)
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  • Manager Risk Adjustment Operations

    Premera Blue Cross (Mountlake Terrace, WA)
    …blog: https://healthsource.premera.com/ . 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 operations team. In this role, you will be responsible for overseeing submissions,… more
    Premera Blue Cross (04/11/25)
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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… more
    UCLA Health (02/19/25)
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  • Risk Adjustment Analyst- HIM OP CDI

    UNC Health Care (Chapel Hill, NC)
    …the health and well-being of the unique communities we serve. Summary: The Risk Adjustment Coordinator will be responsible for analyzing and auditing medical ... by the third party payer under the value care contracts. In addition, the Risk Adjustment Coordinator will be responsible for working the EPIC WQ to reorder the… more
    UNC Health Care (04/29/25)
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  • Risk Adjustment Specialist II…

    Centene Corporation (Des Moines, IA)
    …workplace flexibility. **Candidate must reside in Iowa** **Position Purpose:** Utilize risk adjustment methodologies, principles, and knowledge of managed care ... providers + Develop collaborative relationships with providers to educate and improve Risk Adjustment coding and documentation competencies + Use knowledge of… more
    Centene Corporation (03/27/25)
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