HEDIS & Risk-Adjustment Quality Advisor
Centene Corporation
Centene Corporation seeks a quality-focused HEDIS specialist to educate and support provider practices and IPAs on HEDIS measures, documentation, and coding practices across state and NCQA requirements. You will collect and analyze performance data, coach on gap closure, and collaborate with Provider Relations to drive improvements in quality, risk adjustment, and operational efficiency. Significant travel (up to 75%) to provider offices is required, with a flexible, mission-driven environment. #J-18808-Ljbffr Centene Corporation
- Centene is seeking a Quality Improvement professional to educate provider practices on HEDIS measures and risk adjustment, support documentation, and improve coding accuracy. The role involves extensive travel to physician offices and collaboration with provider relations...HEDISRisk
$27.02 - $48.55 per hour
...and Centene. Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding....HEDISRiskHourly payFull timePart timeWork at officeRemote workFlexible hours- ...thorough, personal care, while building in-demand skills in risk adjustment and quality measures. Find out if this opportunity is a good fit... ...: Prepare pre-visit checklists covering care gaps (HEDIS/Stars), due screenings, HCC risk conditions requiring MEAT...HEDISRiskWork at office
- Mosaic Health, LLC. is seeking a Director of BOI to oversee data reviews and forecasting for the risk adjustment program. You will refine strategies to optimize performance, build vendor relationships, and drive value-based coding initiatives. The role focuses on improving...Risk
- Highmark Inc. is seeking a skilled HCC coder to support risk adjustment coding for Medicare Advantage and ACA programs. You will apply ICD... ...ensuring accuracy and compliance. Collaboration with physicians, Quality, Compliance, and enterprise partners is essential to improve...RiskRemote job
- ...company expertise. Our Crop Division has been helping farmers manage risk since 1915 and is one of the few private companies authorized by... ...part‑time. Hours fluctuate based on seasonal needs. As a Crop Adjuster, You Will Understand and work claims for all major crops,...RiskFull timePart timeSeasonal work
$21.3 - $29.33 per hour
...Crop Claims Specialist or Claims Crop Field Adjuster I KY Zurich is currently looking for a to... ...States Department of Agriculture’s Risk Management Agency. Together with RCIS agents... ...referrals for sake of operations integrity and quality assurance. Protect Zurich’s reputation by...RiskHourly payFull timeTemporary workSummer workWork at officeLocal areaRemote workVisa sponsorshipFlexible hours$2,400 - $10,000 per month
...evaluating current health status, gaps in care, potential health risks and care management opportunities with a focus on driving better... ...the option to opt out. Knowledge of CMS Regulations and NCQA HEDIS Guidelines Knowledge of Evidence-based Clinical Practice Standards...HEDISRiskDaily paidLocal areaRemote work- ...seeking an experienced HCC coder to support Medicare Advantage and ACA risk-adjusted coding remotely. You will apply HCC coding, CMS guidelines, and RADV considerations, collaborating with physicians, quality, compliance, and enterprise leadership to ensure accurate risk...RiskRemote job
- A leading healthcare organization seeks a Consulting Actuary to deliver actuarial services, lead pricing strategies, and evaluate care management models. The ideal candidate will have a Bachelor's degree or higher, membership in the American Academy of Actuaries, and at...Risk
- Highmark Health is seeking a Remote Risk Adjustment Coder to deliver accurate HCC coding for MA, ACA, and ESRD projects, adhering to CMS guidelines and Highmark policies. You will review physician documentation, perform coding across retro and prospective models, and support...RiskRemote jobWork at office
- ...Anxiety disorders ADHD PTSD Adjustment disorders Provide medication management... ...patient-centered care Documentation & Quality Maintain accurate and timely documentation... ...quality measures and screenings (HEDIS, depression remission/follow-up) Comply...HEDISWork at office
$178k - $233k
...looking for a legal counsel to:• act as legal advisor for the Direct Investments Group (DIG)... ...closely with DIG business leads, risk and compliance teams, external counsel,... ...and if you need reasonable accommodation/adjustments throughout our recruitment process, you...RiskFull timeFlexible hours- ...people and their ability to drive real progress. Senior General Adjuster requires knowledge of the Property policy and Business... ...and work with other insurance companies who participate on the risk. Work with Underwriters on policy coverage and assist on policy...RiskWorldwide
$90k - $120k
...Time Key responsibilitiesThe Risk and Liquidity Manager is a critical... ...parameters, and data quality.• Prepare and present risk reports... ...closely with Financial Advisors, the OCIO Team, Portfolio Advisory... ...reasonable accommodation/adjustments throughout our recruitment process...RiskFull timeFlexible hours$155.6k - $306.8k
...Whether focused on project financials, quality and risk management, methods and tools, sales excellence... ..., and delivery to act as a strategic advisor to help manage deal flow and to... ...disclosed range estimate has not been adjusted for the applicable geographic differential...RiskOngoing contractContract workLocal area$130k
...Effectiveness Data and Information Sets (HEDIS) operations. And will collaborate with agency... ...have a Six Sigma projects to improve the quality of services provided.•Develops new and... ...state and federal guidelines. •Recognize risks proactively and utilize appropriate...HEDISRiskTemporary workWork at officeLocal areaWeekend work$134.5k - $265.1k
...Position Summary Cyber Security & Risk Strategy Manager Our Deloitte Cyber team understands... ...change while contributing to high-quality client delivery and practice development.... ...The disclosed range estimate has not been adjusted for the applicable geographic differential...RiskLocal areaVisa sponsorship$141.2k - $278.3k
Position Summary Manager, AI Risk & Validation Our Deloitte Regulatory, Risk & Forensic... ...consultants to strengthen technical quality, delivery discipline, documentation, and... ...disclosed range estimate has not been adjusted for the applicable geographic differential...RiskLocal areaVisa sponsorship$250k
...the firm's largest, highest-risk, and most complex global pursuits... ....Serve as a strategic advisor to business and solution leaders... ...loss aversion, anchoring and adjustment, cognitive load, framing, and... ...management skills to deliver a high-quality work product while navigating...RiskContract workSummer holidayLocal areaFlexible hours$100k - $145k
...within our Broker-Dealer operations. The ideal candidate will play a pivotal role in ensuring seamless operational processes, mitigating risk, and maintaining compliance with regulatory standards. This position requires a proactive approach to identifying inefficiencies,...RiskContract workWork at officeLocal area$120k - $150k
...PricingAt AIG, we are reimagining the way we help customers to manage risk. Join us as a AssociateActuary - North America Property Pricing... ...efforts with cat modeling team to ensure adequate risk-adjusted returns contemplating expected loss, reinsurance costs, and increased...RiskFull timeWork at office$163.4k - $322.1k
...strategic business partners, manage risk, and unlock new levels of... ...user experience.Serve as a senior advisor across multiple concurrent engagements, driving quality, consistency, and successful delivery... ...range estimate has not been adjusted for the applicable geographic differential...RiskLocal areaVisa sponsorship- ...Bring your expertise to JPMorganChase. As part of Risk Management and Compliance, you play a crucial role in maintaining JPMorganChase... ...technical issues to diverse stakeholders and write high quality technical reports. Knowledge of financial products / markets...Risk
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$251k - $377k
...insight to strengthen governance, risk management and internal controls. The role is a trusted advisor to the CFO, executive... ...profile and operating priorities; adjust coverage as conditions change.Lead... ...Oversee the planning, execution, quality and reporting of audits,...RiskTemporary workWork at officeImmediate startFlexible hoursNight shift$130k - $175k
...dollar departmental budgets and proactively managing enterprise risks. Additionally, the Senior Director serves as a key regulatory... ...systems against shifting threat vectors; mandates dynamic policy adjustments to guarantee institutional agility and business continuity....RiskFull timeContract workWork at officeLocal areaWork from homeShift work- ...Bring your expertise to JPMorgan Chase.As part of Risk Management and Compliance, you are at the center of keeping JPMorgan Chase strong and resilient. You help the firm grow its business in a responsible way by anticipating new and emerging risks, and using your expert...Risk
$88.8k
Company DescriptionJob Description As a Security Risk and SOC Responsible , your main focus will be Develop, implement and maintain... ...a flexible portfolio of locations (typically 50-70), with scope adjusted based on evolving business needs Develop and lead a resilient crisis...RiskWork at officeLocal areaFlexible hours- Reveleer is seeking a Clinical Documentation Specialist - Outpatient for a remote opportunity. The role focuses on reviewing patient records to identify and validate HCC diagnoses and to improve RAF score accuracy through provider queries and documentation improvements....RiskRemote job
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