Medicaid Risk Adjustment & Revenue Manager
The Elevance Health Companies, Inc.
The Elevance Health Companies, Inc. seeks a professional to lead Medicaid risk adjustment and revenue initiatives. You'll manage processes for complex financial analysis and compliance while mentoring team members. A Bachelor's in Accounting or Finance and 6+ years of experience are required. Remote work flexibility is available, but collaboration in the office is essential. Strong knowledge of risk adjustment practices and relevant tools like SQL is crucial. #J-18808-Ljbffr The Elevance Health Companies, Inc.
- Elevance Health is seeking a key member for their Medicaid renal/ESRD strategy in Louisville, KY. The role involves defining requirements, performing testing, and ensuring that technical solutions align with business needs. Applicants should hold a BA/BS in Information...RiskRemote work
- ...development of new business strategies for Government Business Risk Adjustment initiatives. Located in Louisville, you will analyze product... ...degree with at least 5 years of experience, particularly in Medicaid and Medicare. Strong communication skills are a must for collaboration...RiskWork at office
- ...plans and strategies for Government Business Risk Adjustment initiatives, including Medicaid specific risk adjustment and specialty revenue assignments, Medicare Advantage [Duals]... ...and trends related to health insurance/managed care and related services. Consolidate data...RiskTemporary workWork at officeLocal area2 days per week1 day per week
$102.96k - $185.33k
Risk Adjustment Strategic Manager Location: Virginia, Indiana, Georgia, Tennessee, Connecticut, New York,... ...compliance with Center for Medicare and Medicaid Services (CMS) program requirements.... ...and accurate coding for Medical Revenue Management programs driving the revenue...RiskTemporary workWork at officeLocal area2 days per week1 day per week- Position Overview A key member in our Medicaid renal/ESRD strategy area for both our Health plans and vendors. Under... ...Director, they will play a key role in both Specialty Revenue [ESRD] as well as Risk Adjustment. How You Will Make an Impact Defines functional, usability...RiskTemporary workWork at officeLocal area2 days per week1 day per week
$142.6k - $261.5k
...Architecture, Assessment Services, Project Management, Business and Technology Analysis, and... ...drive process improvements in the quote‑to‑revenue business processes, including quoting,... ...definition, vendor selection, process and risk analysis, development and customization,...RiskSummer holidayFlexible hours- Elevance Health is seeking a Risk Adjustment Strategic Manager to develop metrics and oversee operations related to risk adjustment programs. Candidates must have a BA or BS and at least 5 years of experience in a managed care environment, focusing on CMS compliance and...RiskWork at office
- ...process of preparation and interpretation of complex risk adjustment, revenue, or financial analysis for the Medicaid line of business. Owns end‑to‑end Medicaid Risk... ...solutions to reduce manual and repetitive work. Manage enterprise or Medicaid business unit activities...RiskWork at officeLocal areaRemote work2 days per week1 day per week
- ...Construction Project Manager Louisville, KY Key Responsibilities Plan, manage, and oversee... ...internal teams. Monitor project progress and adjust plans to address delays, scope changes,... ..., and company policies. Identify risks, resolve issues, and implement corrective...RiskContract workFor subcontractorWork at officeLocal area
- ...reviews and make recommendations for salary adjustments, approve timecards for FTEs and other duties associated with managing a staff Job Responsibilities Design and develop... ...Product, Operations, Compliance, and Risk, to ensure training content is accurate, relevant...RiskWork experience placement
- Job Summary The Revenue Cycle Manager is responsible for overseeing and optimizing the entire revenue cycle process, from patient registration and insurance verification through billing, collections, and payment posting. This role ensures accurate, timely reimbursement...
$270.46k - $386.37k
...Director will directly supervise, performance manage and train Clinical Directors within in... ...processes. Experience of population risk management or complex chronic disease care... ...or equivalent with a Medicare or Medicaid patient population ~ Board eligibility...RiskWork at officeLocal area- ...of that stewardship. The Human Resources Manager leads the day-to-day work of caring for... ...Review compensation changes, promotions, and adjustments before submission for approval Oversee... ...documentation Ensure HR compliance and risk management (10%): Oversee HR compliance...RiskWork at officeLocal area
$129k - $177k
The Senior Program Manager will play a key part on program teams to support the planning... ...controls, benefits management, governance, risk, and stakeholder management. Candidates... ...plan, monitoring progress, and making adjustments as necessary to maximize outcomes....RiskTemporary workWork experience placementWork at officeLocal areaRemote work$96k - $144k
...2025) Day to Day In this role, you will manage multiple complex, cross‑functional AI programs... ...; proactively identify and mitigate risks and cross‑program dependencies; and provide... ...and partners the insight they need to adjust course. Responsibilities Orchestrate program...RiskWork experience placementLocal area- ...Insurance is a privately‑owned insurance agency that has delivered risk management solutions since 1977. With a wide variety of insurance and... ..., peripheral vision, depth perception, and the ability to adjust focus. Work environment characteristics described here are representative...RiskWork at office
$100k - $120k
LeoForce in Louisville, KY, is seeking a Corporate Assurance Analyst to join a dynamic team focused on compliance, governance, and risk management. The role demands a proactive approach to ensure the effectiveness of internal controls and governance processes. Ideal...Risk$85k - $123.3k
...partner with clients to provide both program management and construction management to... ...Identify, assess, and mitigate project risks; develop and maintain Risk and Change Registers... ...to all. If you require reasonable adjustments to be made during the recruitment process...RiskFull timeContract workTemporary workPart timeFor contractorsCasual workInternshipWork at officeLocal areaRelocationFlexible hours- WesBanco Bank Inc. is seeking a Senior Analyst for Model Risk Management in New Albany, Indiana. This role involves implementing and executing Bank-wide MRM policies, model validation, and performance monitoring. The ideal candidate will have a graduate degree in a quantitative...Risk
- Brown-Forman is seeking an IT Governance/Risk/Compliance Analyst to support risk management initiatives and ensure compliance with internal policies and regulations. The ideal candidate will have over 3 years of experience, strong analytical and communication skills, and...Risk
- Position Overview Papa Johns is seeking a Senior Manager, Governance, Risk & Compliance to establish and operate the cybersecurity governance and risk control plane across the enterprise. This role is responsible for enabling risk-informed decision making, clear accountability...RiskFor contractors
$70k - $90k
...are seeking a skilled Residential Project Manager to join our dynamic team. This individual... ..., and ensuring their satisfaction. Risk Management - Identify potential risks and... ...vision, color vision, and the ability to adjust focus. EEOC Lakeview is an Equal Employment...RiskFor contractorsFor subcontractorWork at officeLocal area- ...role as a Business Relationship Manager is for you. As a Business... ...focus on client experience and risk management. Job... ...business clients with annual revenue of $1 - $5 million for your assigned... ...strategies with manager, making adjustments as needed Identify and pursue...RiskWork experience placement
- Encompass Health Corporation, located in Louisville, Kentucky, is looking for a Quality/Risk Director to lead their hospital-wide quality management program. The role involves ensuring compliance with regulations, developing quality improvement programs, and collaborating...Risk
- WesBanco Bank Inc. is actively seeking an Operations Fraud Manager in New Albany, Indiana. This role entails the management and oversight of the Operations Fraud team, ensuring timely processing of fraudulent check affidavits and enhancing customer service. The ideal candidate...Risk
- ...and adherence of company, Environmental Health & Safety, and risk management policies and procedures on construction project. Support identification... ..., peripheral vision, depth perception, and the ability to adjust focus. The employee is regularly required to be mobile, and...RiskPermanent employmentContract workTemporary workFor contractorsFor subcontractorWork at officeLocal areaImmediate startRemote workLong distanceFlexible hours
- Model risk management (MRM) refers to the overseeing of risk defined by potential adverse consequences from decisions based on incorrect or misused models. MRM aims to employ techniques, practices or behaviors that will identify, measure and mitigate model risk across the...Risk
- ...Integrity based in Louisville, KY. This senior position leads the global compliance program, focusing on confidential reporting and risk management. The successful candidate will oversee complex investigations and drive ethical culture across the organization, reporting...Risk
$1,000 per month
...Services Overview The Regional Business Manager is responsible for leading, standardizing... ...enhance service quality, compliance, and revenue performance. Responsibilities Operational... ...updates and payer plan changes. Risk Management & Compliance Conduct internal...RiskContract workFlexible hours- A leading appliance company is seeking a Director of Insurance & Risk Management in Louisville, KY. In this critical role, you will oversee complex insurance programs and lead risk mitigation strategies. The position requires exceptional communication skills and a strong...Risk
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medicaid Risk Adjustment & Revenue Manager. Be the first to apply!

