• Medicare Risk Adjustment

    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 ... 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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  • Business Change Manager - Medicare

    Elevance Health (Mason, OH)
    …Knowledge of SAS and SQL. + Ability to manage multiple projects simultaneously. + Medicare risk adjustment experience highly preferred. Please be advised ... **Business Change Manager ** **Location:** Grand Prairie, TX; Indianapolis, IN; Mason,...and resources + Leading various projects that support the Medicare Risk & Recovery Revenue Management -… more
    Elevance Health (04/04/25)
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  • Risk Adjustment Encounters Analyst…

    Elevance Health (Grand Prairie, TX)
    ** Risk Adjustment Encounters Analyst - Medicare / Medicaid** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate ... of one of our Elevance Health PulsePoint locations. The ** Risk Adjustment Encounters Analyst - Medicare...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (04/03/25)
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  • Business Information Consultant - Medicare

    Elevance Health (Grand Prairie, TX)
    …Strong analytical, organizational, presentation, and problem-solving skills strongly preferred. + Medicare risk adjustment experience preferred. + Experience ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
    Elevance Health (04/04/25)
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  • Risk Adjustment Coding…

    CareOregon (Portland, OR)
    Job Title Risk Adjustment Coding Manager Requisition # 24887 Exemption Status Exempt Management Level Manager Direct Reports Coding Auditors Manager ... reside in Oregon or SW Washington. Job Summary The Risk Adjustment Coding Manager is...adjustment coding and provider education programs for the Medicare Advantage and Medicaid product lines. This function is… more
    CareOregon (03/21/25)
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  • Risk Adjustment Program…

    CVS Health (Jacksonville, FL)
    …an exciting opportunity for a Program Manager to join our Risk Adjustment Retrospective Program for ACA, Medicare , MMP and DSNP lines of business! In ... project manager and subject matter expert in Risk Adjustment chart retrieval & coding programs...production management, and reporting for the Risk Adjustment Retrospective Program for ACA, Medicare , MMP… more
    CVS Health (03/26/25)
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  • Risk Adjustment Strategic…

    Elevance Health (Atlanta, GA)
    …week)** **Position Overview:** Responsible for serving as a strategic partner for the Medicare business to Enterprise Risk Adjustment , Business Operations, ... Assists management by overseeing day to day operations for risk adjustment programs including both prospective and...ensuring the programs are in compliance with Center for Medicare and Medicaid Services (CMS) program requirements + Serves… more
    Elevance Health (03/18/25)
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  • Informatics Manager , Risk

    CVS Health (Columbia, SC)
    …has an exciting opportunity for an Informatics Manager to join our dynamic Risk Adjustment Analytics team! In this role, you will support data analysis, ... Medicare or Medicaid - Knowledge of health insurance concepts - Experience working in risk adjustment - Experience working at a health plan - Attention to… more
    CVS Health (04/02/25)
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  • Prog Mgr, Provider Quality and Risk

    Molina Healthcare (Buffalo, NY)
    …Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures ... complex Value-Based Care contracts have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to… more
    Molina Healthcare (02/23/25)
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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 ... **Job Description:** **JOB SUMMARY** The Director of Actuarial & Risk Adjustment Services is a key leader...excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment.… more
    Marshfield Clinic (03/31/25)
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