- Banner Health (AZ)
- **Department Name:** Risk Adjustment **Work Shift:** Day **Job Category:** General Operations **Estimated Pay Range:** $53.63 - $89.38 / hour, based on location, ... settings by including remote and hybrid opportunities. As the Director of Risk Adjustment , you will lead a dynamic team focused on driving collaboration across… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …right for you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making ... to ensure accurate diagnosis coding. This position is responsible for risk adjustment coding and quality assurance validation for the following programs,… more
- 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
- 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
- Centene Corporation (Harrisburg, PA)
- …the state of Pennsylvania **Position Purpose:** Support the development and maintenance of Risk Adjustment related programs and reporting. Aid in working with ... Risk Adjustment vendors for programs within all...Risk Adjustment vendors for programs within all lines of business....+ Aid in the development and support of company-wide Risk Adjustment initiatives within all product lines… more
- 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
- MVP Health Care (Schenectady, NY)
- Professional, Risk Adjustment Analyst Headquarters Office, 625 State Street, Schenectady, New York, United States of America * Rochester Office, 20 S. Clinton ... and continuous improvement. To achieve this, we're looking for a **Professional, Risk Adjustment Analyst** to join #TeamMVP. This is the opportunity for you if… more
- 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
- Commonwealth Care Alliance (Boston, MA)
- 011260 CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs, ... transformation methodology, and will play an essential role in driving Risk Adjustment (RA) Program performance. Supervision Exercised: * No, this position does… more
- Highmark Health (Des Moines, IA)
- …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
- 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
- Humana (Boise, ID)
- …a part of our caring community and help us put health first** The Risk Adjustment Compliance Professional 2 supports the organization's adherence to governmental ... and contractual requirements, with a focus on risk adjustment operations. The role involves varied work assignments that require analysis, interpretation or… more
- Datavant (Little Rock, AR)
- …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
- 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
- Dignity Health (Bakersfield, CA)
- **Responsibilities** This position is remote.** **Position Summary:** The Risk Adjustment Coding Training Specialist develops and executes comprehensive training ... programs focused on value-based risk adjustment coding. This role ensures that clinicians and value- based coders within the Population Health Services… more
- Datavant (Trenton, NJ)
- …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
- Fallon Health (Worcester, MA)
- …or follow us on Facebook, Twitter and LinkedIn. **Brief Summary of Purpose** : The Risk Adjustment Analyst (RAA) will be a SME for the MassHealth risk ... to improve reporting and product performance. The RAA will represent the Risk Adjustment & Analytics team, participating in corporate project workgroups and team… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of a project. This position is accountable for the performance of vendors within Risk Adjustment . Leads in the identification and selection of vendors by ... to ensure realization of the expected value from the relationship. Executes risk adjustment vendor contracts and contract renewal negotiations. The incumbent… more
- Molina Healthcare (Ann Arbor, MI)
- …Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment program valuation. Maintain SQL/Databricks model, estimate valuations, ... various sources to identify risks. **KNOWLEDGE/SKILLS/ABILITIES** + Build and maintain risk adjustment valuation models (SQL/Databricks). + Collaborate with… more
- UCLA Health (Los Angeles, CA)
- Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... Serve as a key departmental resource for application use related to risk adjustment coding guidelines and gap closure reporting. Salary Range: $76,200 -… more
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