• Senior Risk Adjustment

    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 ... milestones and key deliverables. Develop tracking and monitoring mechanisms for all Risk Adjustment and Coding programs. Support management in ensuring that… more
    CareFirst (11/30/24)
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  • Risk Adjustment Reporting and Data…

    Martin's Point Health Care (NY)
    …software as well as the data warehouse as key sources of data. The Senior Analyst uses their extensive risk adjustment content knowledge and analytical ... "Great Place to Work" since 2015. Position Summary The Risk Adjustment Reporting and Data Analystanalyzes data,...of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding .… more
    Martin's Point Health Care (12/21/24)
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  • Assistant Director of Medicare Advantage…

    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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  • Individual & Family Plans (IFP) Quality Review…

    The Cigna Group (Bloomfield, CT)
    …team objectives + Ability to adhere to CMS and Cigna compliance requirements for Risk Adjustment coding + Demonstrates clear, concise, professional, and ... required. **_Primary Functions:_** The Quality Review and Audit Lead Analyst has daily responsibility for coding reviews...coding reviews and audits in support of IFP Risk Adjustment programs, including but not limited… more
    The Cigna Group (12/31/24)
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  • Senior Medical Economics Analyst - Hybrid

    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 ... (Altamonte Springs,FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating financial and economic data… more
    AdventHealth (12/12/24)
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  • Population Perform Analyst Senior

    Novant Health (NC)
    …Quality, Total Cost of Care, Network Integrity, Social Determinants of Health, Risk Adjustment , and Attribution. + Build compelling visualizations, innovative ... represent key components of Novant Health's strategic goals. The Senior Analyst , Population Performance reports to the Director, Population Performance, and supports… more
    Novant Health (12/18/24)
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  • Sr Analyst , Medical Economics (NY Medicaid…

    Molina Healthcare (Owensboro, KY)
    …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key… more
    Molina Healthcare (12/29/24)
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  • Virtual Currency Data Governance Senior…

    New York State Civil Service (New York, NY)
    …Services, Department of Title Virtual Currency Data Governance Senior Analyst (Financial Services Specialist 2 (Policy Analysis), SG-23) Occupational Category ... otherwise add value to the team;* Ensures consistency by adhering to software coding and style guides;* Provides training and support to dashboard users and ensures… more
    New York State Civil Service (12/03/24)
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  • Finance Manager

    reveleer (Los Angeles, CA)
    …plans across all business lines greater control over their Quality Improvement, Risk Adjustment , and Member Management programs. With one transformative ... every aspect of enrollment, provider outreach and data retrieval, coding , abstraction, reporting, and submissions. Leveraging proprietary technology, robust data… more
    reveleer (10/24/24)
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