- Health First (Rockledge, FL)
- …**Health First Health Plans (Health Insurance)* **Organization:** **HF Administrative Plan Inc* **Title:** *Lead Risk Adjustment Analyst - HFHP Risk ... *POSITION SUMMARY * Contribute to Health First Health Plans Risk Adjustment activities that support compliance with regulatory and contractual requirements… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of key risk ... and actionable reports to solve problems, provide data-driven guidance, and monitor risk adjustment performance. Provide analytical support on various strategies… more
- Martin's Point Health Care (Portland, ME)
- …"Great Place to Work" since 2015. Position Summary **NEW REMOTE POSITION** The Senior Risk Adjustment Analyst analyzes data, reviews findings, and develops ... hoc reporting used in complex conceptual analyses for all departments within Risk Adjustment Operations + Develops systematic reporting processes and procedures… more
- The Cigna Group (Denver, CO)
- **Summary** The Medicare Risk Adjustment Advanced Analytics team is searching for a highly motivated and collaborative person to build new data processes, expand ... and enable analytics. You will work closely with colleagues across the Risk Adjustment business, data science, and data analytics teams to develop new assets,… more
- Molina Healthcare (Richmond, KY)
- **Job Description** **Job Summary** The Sr Analyst , Risk Adjustment - Predicitve Analytics role supports Molina's Risk Adjustment Predictive ... with research, development,and completion of special projects. **Knowledge/Skills/Abilities** + Assist Risk Adjustment Data Analytics Leaders in Prospective and… more
- Baylor Scott & White Health (Columbus, OH)
- **JOB SUMMARY** The Risk Adjustment Analyst Sr (Texas Medicaid Encounter Analyst ) is responsible for monitoring and oversight of the end-to-end encounter ... management workflow. Supports program management activities around risk adjustment data management and submissions to government agencies such as Centers for… more
- Independent Health (Buffalo, NY)
- …on pricing outcomes. + Establish and implement claims review processes to support risk adjustment . Analyze data and provide strategic insights to enhance pricing ... and commitment to diversity and inclusion. **Overview** As a Risk Revenue Analyst -Senior the incumbent will provide...financial performance. + Ensure compliance with CMS regulations and risk adjustment methodologies. + Develop and execute… more
- Citigroup (Getzville, NY)
- The Market Risk Data Lead Analyst is a seasoned professional role focusing on supporting CVA risk data used by risk management professionals charged with ... both internal and external partners domestically and internationally. The Risk Reporting Officer will be part of the ... Control & Data Analytics team supporting Credit Valuation Adjustment (CVA) is responsible for data production and data… more
- Regions Bank (Birmingham, AL)
- …and logging into the careers section of the system. **Job Description:** At Regions, the Risk Quantitative Analyst is a member of a key strategic team that is ... that include stress testing and loss forecasting, economic capital, risk ratings, portfolio valuation, optimization, origination strategies, and other portfolio… more
- New York State Civil Service (Albany, NY)
- …Financial Services, Department of Title Virtual Currency Senior Blockchain Analytics Analyst (Financial Services Specialist 2 (Financial Crime Risk ), SG-23) ... in one (1) of the following:* Evaluating financial institution financial crime risk (BSA/AML, CIP, OFAC/Sanctions, CTF) in a management, compliance, or audit… more
- Elevance Health (Cincinnati, OH)
- **Title: Grievances & Appeals Risk Analyst I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The **Grievances & Appeals Risk Analyst I** will be responsible for responding to inquiries received from regulatory… 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. ... role will be accountable for assigned provider groups reaching risk adjustment related annual metrics. This role...along the engagement continuum within an assigned market. Lead Analyst will be primary contact for provider groups on… more
- Federal Reserve Bank (San Francisco, CA)
- …days, and work from home on others We are looking for a Senior IT Security Analyst to join our 12th District's Information Security Team. You will focus on the needs ... business areas. Additionally you will significantly contribute to cyber security risk management processes, metrics, reports, and other security awareness and… 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 ... healthcare administrative claims data + Works alongside Senior Medical Economics Analyst in identify risk /exposure associated with various reimbursement… more
- CareOregon (Portland, OR)
- …Encounter Data Analyst Exemption Status Exempt Department Finance Manager Title Risk Adjustment Manager Direct Reports n/a Requisition # 24286 Pay and ... claims, data management, EDI experience Preferred + Experience with Medicare Advantage risk adjustment and payment methodologies Knowledge, Skills and Abilities… more
- RELX INC (Atlanta, GA)
- Senior Investigative Analyst Are you looking to utilize your former law enforcement skills in a new career? Do you enjoy using an investigative approach to show ... value and insights while communicating with customers? About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within… more
- General Dynamics Information Technology (Washington, DC)
- …None **Job Family:** Cyber Security **Skills:** Cybersecurity,Cybersecurity Risk Assessment,MITRE ATT&CK Framework **Certifications:** CompTIA - Security+ ... Required:** Yes **Job Description:** How A Cyber Defense Threat Analyst Will Make an Impact + The successful applicant...expected to identify potential cyber threats, determine levels of risk , and produce analytical reports for a variety of… more
- CVS Health (Irving, TX)
- …personal, convenient and affordable. **Position Summary** We are expanding the ACA risk adjustment analytics team to support provider enablement activities. This ... Sr Analyst , Informatics position will serve as a subject matter expert on ACA Risk Adjustment at- risk provider reporting and will be responsible for… more
- Providence (Everett, WA)
- …The Coding Analyst is responsible for detailed diagnostic coding associated with Risk Adjustment and HCC coding. This impacts revenue and CMS compliance with ... and information systems, as well as contracted providers. Coding analyst will have a comprehensive understanding of ICD-9, ICD-10...in development of Health Plan Payment Rules related to risk adjustment . Providence caregivers are not simply… more
- RELX INC (Boca Raton, FL)
- PMO Technical Analyst Do you describe yourself as organized and meticulous? Are you looking for a role whereby you can drive improvement within our Technology Teams. ... LexisNexis(R) Risk Solutions provides customers with innovative technologies, information-based analytics, decisioning tools and data management services that help… more
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