• Director , Quality & Risk

    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 ... of Quality Discipline including metrics and performance standards. Working knowledge of Risk Adjustment . + Project management experience, in a managed healthcare… more
    Molina Healthcare (03/30/25)
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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 ... grievance and appeal management, and client service to drive successful integration with the Risk Adjustment strategy. The Director will work in close… more
    Robert Half Accountemps (04/04/25)
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  • Director of Actuarial and Risk

    Marshfield Clinic (Marshfield, WI)
    …and assistance with strategic positioning of the integrated health system. The Director of Actuarial & Risk Adjustment Services partners with the ... the most exciting missions in the world!** **Job Title:** Director of Actuarial and Risk Adjustment...data-driven solutions that positively impact the improvement of members' health and lower the total cost of care. The… more
    Marshfield Clinic (03/31/25)
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  • Medicare Risk Adjustment , Manager…

    CVS Health (Montgomery, AL)
    At CVS Health , we're building a world of health ...working with providers. This position reports to the Lead Director of Risk Adjustment for the ... ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health ...each and every day. **Position Summary** As the Manager, Risk Adjustment will be responsible for leading… more
    CVS Health (03/30/25)
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  • Sr. Risk Adjustment Administration…

    Humana (Dover, DE)
    **Become a part of our caring community and help us put health first** The Senior Risk Adjustment Administration Professional will work closely with ... improvement opportunities and give guidance around operational and clinical best practices in the risk adjustment methodology. This role reports to the Risk more
    Humana (04/11/25)
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  • Risk Adjustment Coding Manager

    CareOregon (Portland, OR)
    …Exemption Status Exempt Management Level Manager Direct Reports Coding Auditors Manager Title Director , Risk Adjustment Pay and Benefits Estimated hiring ... Job Title Risk Adjustment Coding Manager Requisition #...notes + Advanced ability to work proficiently with electronic health record (EHR) software systems + Strong computer skills,… more
    CareOregon (04/10/25)
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  • Lead Data Analyst (Remote) - Quality, STARS…

    CareFirst (Baltimore, MD)
    … 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 prospective and retrospective ...ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily… more
    CareFirst (03/27/25)
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  • Sr. Data Analyst, Risk Adjustment

    Point32Health (Canton, MA)
    …individual will be responsible for supporting critical data submission functions for the Risk Adjustment Department (RAD), including submissions to CMS and state ... timely resolution of production issues pertaining to state government and risk adjustment data submissions, including issue investigation, business requirements,… more
    Point32Health (04/03/25)
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  • Associate Director , Risk Management…

    Bristol Myers Squibb (San Diego, CA)
    …role has accountability to evaluate, monitor, escalate and report risks to the Sr Director Risk Management and Central Monitoring and/or Global Program Team that ... personal lives. Read more: careers.bms.com/working-with-us . **Position Summary** + The Associate Director , Risk Management and Central Monitoring (AD), is a… more
    Bristol Myers Squibb (04/11/25)
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  • Director , Portfolio Control Manager…

    BMO Financial Group (Chicago, IL)
    …and advisory services to clients around the world. #bmocapitalmarkets **Job Summary:** The Director - Portfolio Control Manager - Risk ID & Appetite role ... Monitor actual risk exposures with the established risk appetite and provide recommendations for adjustment ...well as other perks and rewards. BMO also offers health insurance, tuition reimbursement, accident and life insurance, and… more
    BMO Financial Group (03/14/25)
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