• Risk Adjustment Compliance Director

    Humana (Columbus, OH)
    …our caring community and help us put health first** The Risk Adjustment Compliance Director ensures compliance with governmental requirements. The Risk Adjustment ... capabilities interrelate across the function or segment. The Risk Adjustment Director of Compliance ensures compliance with governmental requirements. This… more
    Humana (03/11/25)
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  • Director, Risk Adjustment

    Centene Corporation (Springfield, IL)
    …a fresh perspective on workplace flexibility. **Position Purpose:** The Director, Risk Adjustment is a key strategic leader responsible for driving the Risk ... Adjustment for various lines of business and achieving related...to improve completeness as well as accuracy of risk adjustment data submitted to CMS and HHS. This leader… more
    Centene Corporation (03/10/25)
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  • Medicare Risk Adjustment Program Manager

    Independent Health (Buffalo, NY)
    …that fosters growth, innovation and collaboration. **Overview** The Medicare Risk Adjustment Program Manager will be accountable for the organization, communication ... and execution of specific HCC risk adjustment activities supporting the Medicare line of business. They...activities that improve the accuracy of the CMS risk adjustment scores of the Medicare Advantage membership. This role… more
    Independent Health (03/04/25)
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  • Manager of Quality - Risk Adjustment

    HCA Healthcare (Campbell, CA)
    …like family! Jump-start your career as a(an) Manager of Quality - Risk Adjustment Programs today with HCA Healthcare. **Benefits** HCA Healthcare, offers a total ... our team as a(an) Manager of Quality - Risk Adjustment Programs. We care for our community! Just last...role leads all aspects of the Quality and Risk Adjustment programs for the SCCIPA network including working closely… more
    HCA Healthcare (02/22/25)
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  • HCC Risk Adjustment Coder

    MedKoder (Mandeville, LA)
    …schedule. Description: MedKoder, LLC is seeking a remote Professional HCC Risk Adjustment Coder who will apply both technical and specialized expertise to help ... while identifying opportunities for increased financial success. The HCC Risk Adjustment Coder provides coding services to health systems and insurance plans… more
    MedKoder (01/14/25)
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  • Prog Mgr, Provider Quality and Risk…

    Molina Healthcare (Rochester, NY)
    …Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures Health Plan's ... have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to...Provider Engagement plan to meet annual quality & risk adjustment performance goals. May engage Tier 2 providers as… more
    Molina Healthcare (02/23/25)
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  • Medicare Advantage Risk Adjustment

    UCLA Health (Los Angeles, CA)
    Description As the Medicare Advantage Risk Adjustment Performance Improvement Consultant, you will be responsible for: + Serving as a Subject Matter Expert (SME) for ... risk adjustment with contracted IPAs + Collaborating with IPAs on risk adjustment strategies to achieve health plan goals and KPIs + Presenting and managing all… more
    UCLA Health (01/24/25)
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  • Risk Adjustment Coder

    Humana (Columbus, OH)
    …part of our caring community and help us put health first** The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes ... and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coder assumes ownership and leads advanced and highly specialized… more
    Humana (03/08/25)
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  • Manager Strategic Risk Adjustment Programs

    Highmark Health (Columbus, OH)
    …job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its ... and achieve strategic objectives relative to new and existing Risk Adjustment Programs. Supports other key objectives designed to build/strengthen patient care… more
    Highmark Health (03/06/25)
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  • Associate, Risk Adjustment Coder

    MVP Health Care (Rochester, NY)
    Associate, Risk Adjustment Coder Headquarters Office, 625 State Street, Schenectady, New York, United States of America * Rochester Office, 20 S. Clinton Ave, ... and continuous improvement. To achieve this, we're looking for an **Associate, Risk Adjustment Coder** to join #TeamMVP. This is the opportunity for you if you… more
    MVP Health Care (03/04/25)
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  • Director of Actuarial and Risk Adjustment

    Marshfield Clinic (Marshfield, WI)
    …in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** 682891378 SHP-Actuarial **Scheduled Weekly Hours:** 40 **Employee ... of America) **Job Description:** **JOB SUMMARY** The Director of Actuarial & Risk Adjustment Services is a key leader for commercial and government program actuarial… more
    Marshfield Clinic (03/04/25)
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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 for… more
    UCLA Health (02/19/25)
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  • Risk Adjustment Coder

    ChenMed (Miami, FL)
    …rapidly expanding and we need great people to join our team. The Risk Adjustment Coder works in a collaborative effort directly with physicians and their office ... to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities. A major focus of the… more
    ChenMed (02/18/25)
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  • Sr. Data Analyst, Risk Adjustment

    Point32Health (Canton, MA)
    …be responsible for supporting critical data submission functions for the Risk Adjustment Department (RAD), including submissions to CMS and state agencies. The ... of production issues pertaining to state government and risk adjustment data submissions, including issue investigation, business requirements, user acceptance… more
    Point32Health (01/03/25)
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  • Regulatory Policy Manager - Credit Valuation…

    HSBC (New York, NY)
    …areas eg credit risk, counterparty credit risk, securitization, and Credit Valuation Adjustment ('CVA'). GRPA currently maintains a presence in key locations across ... with a focus on providing policy guidance on the new Credit Valuation Adjustment ('CVA') capital requirements within the US Agencies' proposed adoption of the 'Basel… more
    HSBC (03/06/25)
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  • Account Adjustment Adjuster

    City of New York (New York, NY)
    …Supervisor for the Account Auditing, Account Maintenance, Accounting and Payment Adjustment units, with some latitude for independent action, the Account Specialist ... recruit seven (7) Bookkeeper II's to function as Account Adjustment Adjusters who will: - Respond verbally and in...batch transactions to reconcile balances, updates account remarks if adjustment to the account occurred, and records case remarks… more
    City of New York (02/23/25)
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  • Risk Adjustment Coder

    Centene Corporation (Tallahassee, FL)
    …and has a complete understanding of these guidelines. + Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines. + Understands ... the impact of ICD-10 codes on the CMS HCC risk adjustment model. + Ability to meet productivity and accuracy standards + Ability to defend coding decisions to both… more
    Centene Corporation (03/08/25)
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  • Business Systems Analyst Risk Adjustment

    Corewell Health (Grand Rapids, MI)
    …Qualifications Required + Bachelor's Degree or equivalent + Must have risk adjustment knowledge and working experience + 5 years of relevant experience in ... - Priority Health - 1231 E Beltline - Grand Rapids Department Name Risk Adjustment Employment Type Full time Shift Day (United States of America) Weekly Scheduled… more
    Corewell Health (03/04/25)
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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 will live ... within 50 miles of one of our Elevance Health PulsePoint locations. The **Risk Adjustment Encounters Analyst - Medicare / Medicaid** is responsible for serving as an… more
    Elevance Health (03/04/25)
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  • Billing Adjustment Coordinator - GWW…

    Sysco (Somerset, NJ)
    **JOB SUMMARY** The Billing Adjustment Coordinator is responsible for the processing of billing and cost adjustments (ie, credits for damaged products, incorrect ... is an applicable invoice or purchase order to apply credit or adjustment against. Research discrepancies and/or obtain and update missing information. + Provide… more
    Sysco (02/16/25)
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