• Manager, Medicaid Risk Adjustment

    CVS Health (Phoenix, AZ)
    …outstanding opportunity for an enthusiastic team player to lead a suite of market focused Risk Adjustment Programs for a portfolio of Aetna Better Health ... Strategy & Execution** + Monitors program or programs that are jointly accountable for risk ...on market specific strategies that drive member engagement in risk adjustment programs . + Stay… more
    CVS Health (02/08/25)
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  • HCC Risk Adjustment Coder

    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 ... expertise to help healthcare programs remain compliant with government regulations while identifying opportunities...while identifying opportunities for increased financial success. The HCC Risk Adjustment Coder provides coding services to… more
    MedKoder (01/14/25)
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  • Sr. Data Analyst, Risk Adjustment

    Point32Health (Canton, MA)
    …up and manage secure file transfer sites for vendors that support our risk adjustment programs . **Collaboration with Internal/External Stakeholders** + ... specific to risk score trends, truncation report, data/claims submissions and program performance to support risk adjustment analytics; deliver timely… more
    Point32Health (01/03/25)
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  • Clinical Documentation Integrity Specialist…

    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
    UCLA Health (02/10/25)
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  • Risk Adjustment Specialist II…

    Centene Corporation (Phoenix, AZ)
    …surrounding Tempe and Tucson, Arizona visiting Providers. **Position Purpose:** Utilize risk adjustment methodologies, principles, and knowledge of managed care ... organizations to increase engagement in provider performance programs utilizing data to develop...Develop collaborative relationships with providers to educate and improve Risk Adjustment coding and documentation competencies. +… more
    Centene Corporation (02/08/25)
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  • Risk Adjustment Provider

    Medical Mutual of Ohio (OH)
    …and perform pre-employment substance abuse and nicotine testing._ **Title:** _Risk Adjustment Provider Programs Specialist_ **Location:** _Ohio_ ... plans. _Collaborates with internal departments on risk adjustment coding strategies, HEDIS performance, provider performance,...as project manager over large internal risk adjustment projects (eg, Optum In Office Assessment program more
    Medical Mutual of Ohio (12/06/24)
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  • Risk Adjustment Senior Data…

    Elevance Health (Mason, OH)
    ** Risk Adjustment Senior Data Reporting Analyst** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will live within ... 50 miles of one of our Elevance Health Pulse Point locations. The ** Risk Adjustment Senior Data Reporting Analyst** is responsible for translating most highly… more
    Elevance Health (01/29/25)
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  • Medicare Risk Adjustment Advanced…

    Elevance Health (Norfolk, VA)
    ** Risk Adjustment Advanced Analyst Senior** **Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles ... of one of our Elevance Health PulsePoint locations.** The ** Risk Adjustment Advanced Analyst Senior** is responsible for creating statistical models to predict,… more
    Elevance Health (01/10/25)
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  • Sr Risk & Quality Performance Manager…

    Molina Healthcare (Chandler, AZ)
    …& ABILITIES:** * 4+ years of program and/or project management experience in risk adjustment and/or quality * 4+ years of experience supporting HEDIS engine ... limited to: Risk /Quality rate trending and forecasting; provider Risk /Quality measure performance, CAHPS and survey...activity, risk adjustment targeting and reporting systems *… more
    Molina Healthcare (02/07/25)
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  • Director, Risk Score Accuracy

    Healthfirst (NY)
    …and Responsibilities** + Assume leadership role in the delivery and execution of the risk adjustment program by driving value through data driven decisions ... for quantitative analysis + Minimum ten (10) years' experience in a combination of quality, provider engagement and/ risk adjustment , with at least 3 years in… more
    Healthfirst (12/23/24)
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