• Director of Medicare Risk Adjustment

    Elevance Health (Columbus, OH)
    **Director of Medicare Risk Adjustment Analytics and Reporting** **Location:** This position will work a hybrid model (remote and office). The ideal ... our Elevance Health PulsePoint locations. The **Director of Medicare Risk Adjustment Analytics and Reporting**...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (11/21/24)
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  • Manager Strategic Risk

    Highmark Health (Columbus, OH)
    …requires the incumbent to: + **Lead and manage a team of interoperability and risk adjustment SMEs:** Provide guidance, mentorship, and support to team members, ... accurate and timely data flow across systems. + **Oversee risk adjustment processes and ensure compliance with...procedures. + **Analyze data and identify trends:** Utilize data analytics to identify patterns, trends, and potential areas for… more
    Highmark Health (10/08/24)
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  • Manager Data Risk Adjustment

    System One (Houston, TX)
    …is seeking a qualified Manager level candidate to oversee their Data Risk and Analytics team. This individual will have direct responsibilities to conduct ... and oversee risk assessment and data analytics to ensure...risk score tracking and improvement. + Maintains internal risk adjustment models using published documentation. +… more
    System One (11/23/24)
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  • Sr. Data Analyst, Risk Adjustment

    Point32Health (Canton, MA)
    …and Operations, this individual will support the operations and analysis of risk adjustment strategy across Point32Health business lines. The Data Analyst ... will assist in managing vendor relationships, monitoring risk adjustment program operations, performing detailed analysis and synthesizing results to develop… more
    Point32Health (11/16/24)
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  • Assistant Director Medicare Advantage Risk

    UCLA Health (Los Angeles, CA)
    …compliance officer and the manager of coding and education. The Assistant Director of Risk Adjustment will oversee the manager of the coding team and our ... can do all this and more at UCLA Health. As member of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director of Risk Adjustment more
    UCLA Health (11/27/24)
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  • Actuarial Analyst III - Medicare Risk

    Elevance Health (St. Louis, MO)
    …complex actuarial studies. **How you will make an impact:** + Insources Medicare Advantage Risk Adjustment Analytics from vendors. + Analyzes and implements ... background. **Preferred skills, capabilities, and experiences:** Medicare Advantage and/or Medicaid Risk Adjustment experience is strongly preferred. Please be… more
    Elevance Health (10/30/24)
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  • Manager , Analytics

    LA Care Health Plan (Los Angeles, CA)
    Manager , Analytics Job Category: Accounting/Finance Department: Risk Adjustment Strategies & Initiatives Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Manager , Analytics is responsible for planning and...systems. Analytics experience in management, actuarial/healthcare economics, risk adjustment and quality improvement programs. … more
    LA Care Health Plan (11/09/24)
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  • Market Risk & Counterparty Risk

    PNC (Raleigh, NC)
    …oversight, of some of PNC's most important models, including interest rate models, securities risk analytics models, derivative pricing models, Value at Risk ... to contribute to the company's success. As a Quantitative Analytics /Modeling Expert within PNC's Model Risk Management...at PNC. The position reports to the Senior Validation Manager for Market Risk and Counterparty … more
    PNC (10/10/24)
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  • Financial Crimes Blockchain Analytics

    New York State Civil Service (New York, NY)
    NY HELP No Agency Financial Services, Department of Title Financial Crimes Blockchain Analytics Risk Associate (Financial Services Specialist 4 (Financial Crime ... Financial Services is seeking candidates for the position of Financial Crimes Blockchain Analytics Risk Associate in the Virtual Currency Unit. Duties include,… more
    New York State Civil Service (09/19/24)
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  • Manager Analytics , IHCI

    Community Health Network (Indianapolis, IN)
    Manager Analytics , IHCI Job Ref 2406244 Category Leadership Job Family Data Analytics Department Analytics Schedule Full-time Facility Shadeland Station ... model. We are searching for candidates with experience with medical economics, risk adjustment , quality reporting, and/or clinical stratification. The individual… more
    Community Health Network (09/14/24)
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  • Manager , Clinical Quality Analytics

    LA Care Health Plan (Los Angeles, CA)
    …Informatics Experience Required: At least 6 years of experience in HEDIS, quality improvement, risk adjustment analytics , research, or related work within a ... Manager , Clinical Quality Analytics Job Category: Clinical Department: Quality Improvement Location: Los Angeles, CA, US, 90017 Position Type: Full Time… more
    LA Care Health Plan (11/27/24)
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  • Lead Risk & Quality Performance…

    Molina Healthcare (UT)
    …(RQS) team by overseeing large programs and multiple projects supporting Molina's Risk Adjustment and Quality performance. This position collaborates with ... **Job Description** **Job Summary** The Lead Risk and Quality Performance Manager supports...6+ years of program and/or project management experience in risk adjustment and/or quality * 6+ years… more
    Molina Healthcare (11/07/24)
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  • Manager , Risk & Quality Systems…

    Molina Healthcare (NY)
    …SKILLS & ABILITIES:** * 8+ years of program and/or project management experience in risk adjustment and/or quality * 4-6 years of experience supporting HEDIS ... program performance by supporting development of meaningful reporting and analytics including but not limited to: Risk /Quality...engine activity, risk adjustment targeting and reporting systems *… more
    Molina Healthcare (11/29/24)
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  • Manager Product Analytics , Medical…

    Healthfirst (NY)
    …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRGs), ... + 4+ years of experience in the managed care industry related to analytics . + Extensive knowledge of managed care financial metrics (PMPM, util/k, cost/unit). +… more
    Healthfirst (11/09/24)
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  • Risk & Quality Performance Manager

    Molina Healthcare (NE)
    …SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS ... **Job Description** **Job Summary** The Risk & Quality Performance Manager position...engine activity, risk adjustment targeting and reporting systems *… more
    Molina Healthcare (11/23/24)
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  • Director, Data Quality Analytics

    Citigroup (New York, NY)
    …and results. This is a leadership role within the CSCO Controllers Adjustment Reduction, EUC and Data Initiatives organization responsible for managing a global ... on diverse range of internal and external sources + Appropriately assess risk when business decisions are made, demonstrating particular consideration for the firm's… more
    Citigroup (11/29/24)
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  • Senior Network & Provider Analytics Analyst

    Point32Health (Canton, MA)
    …care claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment . In-depth health care reimbursement and managed care business ... Working under the direction of the Director or Senior Manager , the Senior Analyst will be part of a...Analytics Analyst may also serve as a project manager and/or lead cross functional teams for certain related… more
    Point32Health (11/22/24)
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  • Lead Commodity Risk (NGL)

    BP Americas, Inc. (Houston, TX)
    …and information technology skills underpinned by a world class finance, control, compliance, risk analytics and management infrastructure. The Commodity Risk ... & Control Processes. The position reports to the Senior Manager of Commodity Risk . **Key Accountabilities** +...is achieved through timely, rigorous, and accurate reporting and analytics of exposure, market risk , costs, gross… more
    BP Americas, Inc. (11/19/24)
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  • Virtual Currency Financial Crimes Risk

    New York State Civil Service (Albany, NY)
    …No Agency Financial Services, Department of Title Virtual Currency Financial Crimes Risk Associate (Financial Services Specialist 4 (Financial Crime Risk ), ... Compliance; ABA Certificate in Fraud Compliance; Certified Regulatory Compliance Manager .* CSBS: Certified Anti-Money Laundering Specialist.* Demonstrated experience with… more
    New York State Civil Service (11/27/24)
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  • Clinical Quality Program Manager III

    LA Care Health Plan (Los Angeles, CA)
    …Quality Improvement/ Quality Performance Management QI/QPM and Health Information Management (HIM) analytics support, Risk Adjustment , other plan operations ... LAC including but not limited to QI, Pharmacy, Care Management, Utilization Management, Risk Adjustment , Products, Customer Solution Center (CSC), reporting and … more
    LA Care Health Plan (11/07/24)
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