- Martin's Point Health Care (Portland, ME)
- …Plan which is growing and making an impact! Apply today for immediate consideration! The Senior Risk Adjustment Analyst in our Health Plan analyzes ... the data warehouse as key sources of data. The Senior Analyst uses their extensive content knowledge...used in complex conceptual analyses for all departments within Risk Adjustment Operations + Develops systematic reporting… more
- Avera Marshall (Sioux Falls, SD)
- …career growth. Exciting opportunity to join Avera as a Senior Quality and Risk Adjustment Analyst ! Position Highlights: + Paid Time Off (PTO) available ... + Career Growth opportunities! Job Summary The Senior Quality & Risk Adjustment Analyst is responsible for designing and maintaining reporting assets and… more
- CVS Health (Hartford, CT)
- …to make health care more personal, convenient and affordable. Position Summary The Medicaid Risk Adjustment Sr. Analyst will play a critical role in ... and other business needs. Reporting to the Sr. Manager of Medicaid Risk Adjustment Analytics, the Sr. Analyst will work closely with cross-functional… more
- The Cigna Group (Bloomfield, CT)
- ** Risk Adjustment Provider Educator** **_Incumbent_** **_candidate must reside in assigned territory and have the ability to travel to the local office and ... to base salary._** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment program for assigned populations in an operational market.… 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, ... required to achieve that purpose. Job Summary The Enterprise Risk Adjustment Analyst III will...senior leadership based on analytics outcome. Knowledge of risk adjustment processes for multiple lines of… more
- Bloomberg (New York, NY)
- …regulators, clients, and other external stakeholders continue to evolve. We are looking for a Senior Risk Analyst who will develop a deep understanding of ... and be able to analyze and understand the inherent risks within our processes. The Senior Risk Analyst will be accountable to perform detailed analytics work… more
- The Cigna Group (Houston, TX)
- **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment & Stars program for assigned populations in an operational ... market. The role will be accountable for assigned provider groups reaching risk adjustment and stars related annual metrics. This role will work directly with… more
- Truist (Charlotte, NC)
- …of the Market and Liquidity Risk Management (MLRM) team within the Risk Management Organization (RMO), works with the Senior Treasury Market and Liquidity ... tools and processes. Preferred Qualifications: 1. Industry certification such as Chartered Financial Analyst (CFA) or Financial Risk Manager (FRM). 2. 2-5 years… more
- AdventHealth (Maitland, FL)
- …in understanding professional and facility claims and managed care concepts such as risk adjustment , capitation, FFS, DRG, APG, APCs and other payment mechanisms ... 3 days at the office (Altamonte Springs,FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating… more
- RELX INC (Houston, TX)
- Senior Market Analyst - North American Isocyanates & Polyols Do you enjoy being part of a team that works with a diverse range of products /technology? Do you ... of major producers, converters, traders, and the financial markets. About the Role The Senior Market Analyst is responsible for managing all market products for… more
- Healthfirst (New York, NY)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... it needs to produce results and deliver impactful business recommendations. As a Senior Medical Economics Analyst , you'll map out and construct detailed… more
- Dow Jones (New York, NY)
- …Mansion Global, Financial News, Investor's Business Daily, Factiva, Dow Jones Risk & Compliance, Dow Jones Newswires, OPIS and Chemical Market Analytics. ... important role in year-end processes and will have direct interaction with senior -level executives. Strong data analytics and data integrity skills are necessary for… more
- The Cigna Group (Chattanooga, TN)
- …**Job Summary:** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment program for assigned populations in an operational market. ... The role will be accountable for assigned provider groups reaching risk adjustment related annual metrics. This role will work directly with providers to assist… more
- Providence (OR)
- …the rate development and filing efforts including competitive analysis, network analysis, risk adjustment , trend, actuarial benefit value analysis, rate adequacy ... we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Commercial Pricing who will:** + Analyze the financial performance of… more
- CVS Health (Topeka, KS)
- …+ Charlottesville, VA + San Antonio, TX + Southern, IL Position Summary This Senior Analyst , Healthcare Quality Management will be a Quality Practice Liaison who ... + Knowledge of HEDIS and Pay for Performance metrics, ICD-10 coding, Medicaid risk adjustment methodology, and common billing and common billing practices +… more
- Bausch Health (Bridgewater, NJ)
- …improving people's lives with our health care products. As a Sr Cybersecurity Analyst , you will help secure Bausch Health infrastructure against both inside and ... standards, tools, policies, and procedures to improve security, compliance and risk management activities based on security operations findings, or security events… more
- Actalent (Durham, NC)
- …to implement process (eg, SOP) and technology enhancements (eg, new applications). b. Mentor Analyst Programmer I and II staff as needed. c. Educate others in formal ... and informal settings. d. Help with risk assessment and quality improvement activities by participating in...request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process… more
- Highmark Health (Dover, DE)
- …Healthcare-related field **Substitutions** + 6 years of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS, and/or health ... None **EXPERIENCE** **Required** + 5-10 years of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS, and/or health… more
- UCLA Health (Los Angeles, CA)
- …variety of topics, including pricing, forecasting, reserving, trend analysis, value-based care, and risk adjustment - mainly focusing on MAPD business. This will ... time management, and organizational skills + Ability to work effectively with senior staff and managers + Computer proficiency, including advanced knowledge of Excel… more
- Centene Corporation (New York, NY)
- …development. Collaborates with corporate and market quality leaders, provider engagement, risk adjustment and other Operations business owners or ... cross-functional work groups to develop and implement efficient and effective provider quality workflows, and decision support systems to support ongoing improvements of clinical quality and member experience metrics. Directs and facilitates provider quality… more