• Risk Adjustment Compliance…

    Humana (Santa Fe, NM)
    …understanding of how organization capabilities interrelate across the function or segment. The Risk Adjustment Director of Compliance ensures compliance with ... more
    Humana (03/11/25)
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  • Director of Actuarial and Risk

    Marshfield Clinic (Marshfield, WI)
    …come together to support the most exciting missions in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** ... more
    Marshfield Clinic (03/04/25)
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  • Medical Director , Medicare Strategy

    BlueCross BlueShield of North Carolina (NC)
    …Arrangements (ACO/CIO) and Medicare Quality Initiatives (Stars and Risk Adjustment ). + Excellent presentation, communication and relationship building ... more
    BlueCross BlueShield of North Carolina (02/05/25)
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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 ... more
    CareOregon (03/21/25)
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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 ... more
    Point32Health (01/03/25)
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  • Medical Director Physician Engagement…

    Mount Sinai Health System (New York, NY)
    adjustment with a group of practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This ... more
    Mount Sinai Health System (03/04/25)
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  • Director , Actuary

    WelbeHealth (Los Angeles, CA)
    …Python, R), Excel, and financial modeling tools + Deep understanding of CMS risk adjustment , Medicaid rate-setting, and Medicare Advantage/Part D payment ... more
    WelbeHealth (03/14/25)
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  • IPA Coding Associate Director

    CenterWell (Pierre, SD)
    …+ Ability to travel up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record of ... more
    CenterWell (03/06/25)
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  • Senior Medical Director

    CVS Health (Aurora, CO)
    …+ Utilization Management + Network Management + Health Plan Management + Documentation/ Risk Adjustment + Clinical Compliance & Policy Development + This ... more
    CVS Health (03/22/25)
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  • Medical Director (Nebraska)

    Molina Healthcare (Omaha, NE)
    …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... more
    Molina Healthcare (03/13/25)
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  • Director , 340B Policy Strategy

    Bristol Myers Squibb (Washington, DC)
    …every treatment we pioneer. Join us and make a difference. **Position Summary** The Director , 340B Policy Strategy, will serve as a deep technical expert in the ... more
    Bristol Myers Squibb (03/23/25)
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  • Director , Population Health

    CVS Health (Chicago, IL)
    …health, transitions-in-care, pharmacy and medication adherence, HEDIS / Stars, accurate risk adjustment , preferred partner relationships, and remote monitoring. ... more
    CVS Health (03/23/25)
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  • Provider Collaboration Director -Tennessee

    Elevance Health (Nashville, TN)
    …and engages appropriate resources for solution. + Collaborates with Care Consulting, Pharmacy, and Risk Adjustment teams to drive Cost of care and HEDIS Star ... more
    Elevance Health (03/04/25)
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  • Population Health Director , Field

    CVS Health (Des Moines, IA)
    …to, transitions-in-care, pharmacy and medication adherence, HEDIS / Stars, accurate risk adjustment , preferred partner relationships, and patient engagement ... more
    CVS Health (03/22/25)
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  • Social Work Care Manager

    AdventHealth (Hinsdale, IL)
    …coordinates and facilitates the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for individuals from at- ... more
    AdventHealth (03/14/25)
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  • Social Worker/Nurse- Care Manager Weekend Worker…

    AdventHealth (Shawnee, KS)
    …coordinates and facilitates the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for individuals from at- ... more
    AdventHealth (03/05/25)
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  • Coding Auditor

    CareOregon (Portland, OR)
    …# 24856 Exemption Status Exempt Management Level n/a Direct Reports n/a Manager Title Director Risk Adjustment Department Finance Pay and Benefits Estimated ... more
    CareOregon (03/11/25)
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  • Medical Coding And Billing Analyst

    CenterLight Health System (NY)
    …on current performance. + Serves as a subject matter expert on Risk Adjustment Data Validation (RADV) audits from Medicare . + Perform random audits of coding ... more
    CenterLight Health System (03/08/25)
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  • Coding Specialist

    VNS Health (Manhattan, NY)
    …reimbursement related issues; makes coding and documentation recommendations for adherence to risk adjustment models. + Reviews medical documentation to ensure ... more
    VNS Health (02/11/25)
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  • Reg Mgr, Value-Based Prgms

    Molina Healthcare (Owensboro, KY)
    …quality and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of Value Based Programs, medical economics/actuaries and local health ... more
    Molina Healthcare (03/13/25)
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