• Risk Adjustment Provider

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …identify opportunities for performance improvement and further education . + Summarize and provide feedback to risk adjustment and/or provider group ... Establish and maintain collaborative relationships with assigned providers / provider offices to improve risk adjustment... Adjustment Coding/Auditing and experience with direct provider education + Health Insurance/ managed care… more
    Blue Cross Blue Shield of Massachusetts (05/10/25)
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  • Risk Adjustment Developer

    Commonwealth Care Alliance (Boston, MA)
    …claims, encounters, diagnoses, and provider data. + Familiarity with CMS risk adjustment methodologies and HCC coding preferred. + Experience with data ... the Director of Encounter Data Management within the Revenue Cycle Department, the ** Risk Adjustment Data Developer** is responsible for the design, development,… more
    Commonwealth Care Alliance (05/23/25)
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  • Risk Adjustment Business Analyst

    Commonwealth Care Alliance (Boston, MA)
    …without reminders or prompting from management. * Working knowledge of the provider -based healthcare industry and Risk Adjustment preferred. Required ... 011260 CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible...ensuring all identified gaps are addressed timely * Support Provider Network Management * Associate will be responsible for… more
    Commonwealth Care Alliance (05/23/25)
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  • Risk Adjustment Coding Professional

    Humana (Boston, MA)
    …a part of our caring community and help us put health first** The Risk Adjustment Coding Professional conducts quality assurance audits of medical records and ... for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coding Professional work assignments are often straightforward and… more
    Humana (05/30/25)
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  • Risk Adjustment Compliance…

    Humana (Boston, MA)
    …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...vary based on demonstrated job related skills, knowledge, experience, education , certifications, etc. $65,000 - $88,600 per year This… more
    Humana (05/22/25)
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  • Risk Adjustment Trainer

    Datavant (Boston, MA)
    …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 (05/07/25)
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  • Director, Strategy Advancement, Risk

    Humana (Boston, MA)
    …part of our caring community and help us put health first** The Director, Risk Adjustment Strategy Advancement will provide business intelligence and ... business segments and the company at large. The Director, Risk Adjustment Strategy Advancement requires an in-depth...Requirements** + WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a… more
    Humana (05/29/25)
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  • Sr Program Manager

    Point32Health (Canton, MA)
    …will be responsible for the implementation, execution and general ownership of risk adjustment programs, including chart reviews, in-home health assessments, ... data decision support and other new programs for the Risk Adjustment department. The Sr. Program Manager...the company. The Sr. Program Manager will also support provider engagement and consultation efforts by serving as an… more
    Point32Health (05/14/25)
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  • IPA Coding Associate Director

    CenterWell (Boston, MA)
    …with MRA Strategy and Analytics teams to establish risk adjustment analytics to identify coding improvement opportunities, provider coding improvement ... entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing… more
    CenterWell (04/24/25)
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  • Coordinator of Special Education (COSE)…

    Boston Public Schools (Boston, MA)
    …for students with disabilities, and differentiated instruction for all students + Provide support to special education teachers regarding research-based and ... , Mentally Disabled Special Education , Mild/Moderate Disabilities Special Education , Multiple Disabilities Student Services, Adjustment Counselor Student… more
    Boston Public Schools (05/25/25)
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  • Coordinator of Special Education (COSE)…

    Boston Public Schools (Boston, MA)
    …for students with disabilities, and differentiated instruction for all students + Provide support to special education teachers regarding research-based and ... Special Education Director Special Education , General Special Education Student Services, Adjustment Counselor Student Services, Psychologist Student… more
    Boston Public Schools (03/21/25)
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  • Coordinator of Special Education (COSE)…

    Boston Public Schools (Boston, MA)
    …for students with disabilities and differentiated instruction for all students. + Provide support to special education teachers regarding research-based and ... Job Details Job ID: 5048995 Job Description Title: Coordinator of Special Education (COSE) - Central Office and School-Based Compliance Boston Public Schools seeks… more
    Boston Public Schools (03/21/25)
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  • Market Partnership and Finance Strategy Lead - MRA

    CenterWell (Boston, MA)
    …efficiencies, processes, education , and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct process improvement efforts ... and Finance Strategy Lead - MRA in the PCO risk adjustment area implements and supports strategy...bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment… more
    CenterWell (04/26/25)
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  • Sr. Director, Life Underwriting Innovation (Remote…

    RELX INC (Cambridge, MA)
    …LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Insurance vertical, we provide customers with solutions and decision ... and analytics to assist them in evaluating and predicting risk and enhancing operational efficiency. Our insurance risk...the vertical market. + Partner with the Industry Market Education team to monitor state and federal legislative, policy,… more
    RELX INC (04/30/25)
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  • Senior Financial Analytics Professional

    Humana (Boston, MA)
    …This position utilizes financial projection and analytics skills while working in Medicare risk adjustment . Additionally, you will work to build consensus with ... with Medical Claims or other healthcare data + Medicare Risk Adjustment Experience + Financial or actuarial...bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment… more
    Humana (05/29/25)
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  • Associate Director, Clinical Data Management

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …delivery of high-quality, trustable clinical data to support key initiatives around quality, risk adjustment , medicare stars, and interoperability. This is a key ... + Collaborate with cross-functional teams, including clinical operations, performance measurement, and risk adjustment , to execute on data procurement & usage… more
    Blue Cross Blue Shield of Massachusetts (05/29/25)
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  • Data Analyst III

    RELX INC (Cambridge, MA)
    About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Business Services vertical, we offer a multitude of ... Laundering/Counter Terrorist Financing, Identity Authentication & Verification, Fraud and Credit Risk mitigation and Customer Data Management. You can learn more… more
    RELX INC (04/12/25)
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  • Social Worker, LICSW

    Harvard University (Cambridge, MA)
    …of a diverse population of adolescents and adults, eating disorders; multicultural adjustment issues; fluency in a foreign language (Chinese, Japanese, Korean, or ... pre-employment reference and background screening. + Harvard University is unable to provide work authorization and/or visa sponsorship. + This position has a 90-day… more
    Harvard University (05/09/25)
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  • Product Manager I (Remote US)

    RELX INC (Cambridge, MA)
    About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Business Services vertical, we offer a multitude of ... Counter Terrorist Financing, Identity Authentication & Verification, Fraud and Credit Risk mitigation and Customer Data Management. You can learn more about… more
    RELX INC (05/30/25)
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  • (Slife) Social Worker (Sy25-26)

    Boston Public Schools (Boston, MA)
    …Certification by the Commonwealth of Massachusetts Department of Elementary and Secondary Education as a School Adjustment Counselor/School Social Worker + ... 5060577 Job Description Students with Limited or Interrupted Formal Education (SLIFE) Social Worker Office of Social Work(OSW) &...support plan for each student within the program. + Provide or coordinate mental health services for students on… more
    Boston Public Schools (03/27/25)
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