Director of Risk Adjustment & HEDIS Excellence
$165k - $220kAltais Inc.
A healthcare organization located in California is seeking a Documentation Integrity Manager to ensure comprehensive and compliant documentation integrity programs related to risk adjustment and HEDIS/Stars Quality measures. The ideal candidate will have over 10 years of experience, particularly in Managed Care, and will be responsible for developing provider education strategies, ensuring accurate member documentation, and liaising with various clinical teams. Competitive salary offers range from $165,000 to $220,000 annually, reflecting experience and qualifications. #J-18808-Ljbffr Altais Inc.
$165k - $220k
...efficient and compliant documentation integrity program (risk adjustment and HEDIS/Stars Quality measure documentation). Works directly with... ...lead with integrity and vision, setting the standard for excellence in physician support and healthcare innovation. Through collaboration...HEDISLocal area$198.22k - $297.33k
Job Overview Sr. Director, Risk Adjustment Data & Analytics (Remote) is a senior technical and operational... ..., CMS reporting requirements, HEDIS, STAR ratings, interoperability and general... ...advanced spreadsheet modelling using Excel or Google Sheets. Advanced SQL data querying...HEDISRemote work$102k - $115k
...Compensation: $102,000 - $115,000 / year Department: Quality - Risk Adjustment Description Astrana Health is seeking Manager - Risk... ...Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team What You’ll Do Oversee...SuggestedWork at officeRemote work- ...commitment. We have an opportunity to join the Alliance as the Risk Adjustment Director leading the Risk Adjustment Department. This position can... ...care industry, with expertise in risk adjustments Excellent communication skills, with strength in building relationships...SuggestedFull timeContract workTemporary workPart timeLive inWork at officeLocal areaRemote work
- The Alliance seeks a Risk Adjustment Director in California or hybrid. This role involves overseeing risk adjustment functions, managing the team, and providing expert advice on coding methodologies. Ideal candidates are seasoned leaders in managed care with substantial...SuggestedRemote jobLocal area
$73.53k - $91.92k
...Work. Explore. as a part of our Risk team at the Oasis at Death... ...local springs. We’re hiring a Director of Risk to Live. Work. Explore... ...oral reports. Proficiency in Excel, Word, PowerPoint, Internet, and... ...effectively with the public, adjusters, brokers, attorneys, and co-workers...Work at officeLocal areaImmediate startAfternoon shift$150k - $170k
...individuals who are considered high-risk due to chronic illnesses,... ...Operate with Integrity & Excellence Be Innovative Work As One Team... ...end-of-life care. Monitor and adjust palliative interventions based... ...experience preferred). Experience in HEDIS and HCC Environmental Job...HEDISFull time- E2E Alignment Healthcare USA, LLC is seeking a Sr. Director, Risk Adjustment Data & Analytics (Remote) to lead MRA data operations. This senior role is pivotal in ensuring complete and timely data that supports strategic decision-making in Medicare initiatives. Ideal candidates...Remote job
$102k - $115k
A healthcare organization is seeking a Manager - Risk Adjustment to lead risk adjustment initiatives, ensuring accurate documentation and compliance within the healthcare framework. You will oversee operations, coordinate with medical providers, and manage incentive programs...Remote job$172.36k - $258.55k
...need it most. The Sr. Director of Advanced Practice Clinicians... ..., and clinical excellence of our APC team across... ...accuracy, readmission rates, HEDIS ratings, and patient... ..., preferably in a high‑risk clinic and/or home‑... ...vision and ability to adjust focus. Equal Opportunity...HEDISRemote job$45 - $58 per hour
...the case management of high risk or complex clinical patients... ...responsibility for a unit’s staff, HEDIS, compliance and clinical... ...making or recommending necessary adjustments; following hospital and... ...required to perform the job: Excellent verbal, written and interpersonal...HEDISFull timeShift work- ...growth, retention, Annual Wellness Visits (AWVs), HEDIS gap closures, hospital and ER utilization, risk adjustment, and other quality indicators. Conduct initial... ...analytic, quantitative, and problem‑solving skills. Excellent verbal and written communication skills; strong...HEDISRemote jobWork at officeFlexible hoursWeekend workAfternoon shiftEarly shift
$180k - $200k
Join to apply for the Sr. Director - Advanced Analytics & Business... ...actionable insights across risk adjustment, clinical operations, quality... ...Operate with Integrity & Excellence Be Innovative Work As One Team... ...Experience in working with HCC/HEDIS/Clinical Analytics...HEDISFull timeWork experience placementWork at officeRemote work$87.05k - $115.27k
..."A" grade in patient safety from The Leapfrog Group, Patient Safety Excellence recognition from Healthgrades, and more. For more information, visit Responsibilities The Director of Quality and Risk Management is a Registered Nurse (RN) responsible for leading the organization...Daily paidFull timeTemporary workPart timeLocal areaShift work$70k - $102k
...Notify appropriate personnel of necessary actions, including adjusting journal vouchers. Act as a liaison and meet with staff monthly... ...Proficiency in grant management software and accounting systems. Excellent organizational skills and attention to detail. Ability to work...Contract workWork at office- ...opportunity offers a team-oriented approach to patient care, with excellent sub-specialty support and recognition for an award-winning work... ...Requirements: Prior experience with and in-depth knowledge of HEDIS and STAR quality measures MD/DO degree required Licensed or...HEDISLive in
- ...understanding of Medicare Advantage, the CMS Star Ratings Program, HEDIS measures, CAHPS/HOS surveys, and pharmacy data (PDE). The... ...Specific vision abilities required by this job include close vision and the ability to adjust focus. #J-18808-Ljbffr Alignment Healthcare LLCHEDIS
$121k - $150k
Central Risk Manager (RBQM & Central Monitoring) - Remote: United States or Canada Are... ...realities Recommend strategic adjustments to monitoring activities, resource allocation... ...and applicable regulatory requirements Excellent verbal and written communication skills...Remote jobContract work- ...Qualifications Knowledge and an understanding of managed health care. Excellent problem‑solving skills, especially in framing business problems... ...health care data, especially in the context of health equity, HEDIS measures, or the social determinants of health. Experience...HEDIS
$149.88k - $224.82k
...of forecasting models for the Star Ratings Program, including risk‑adjusted simulations, and maintain performance monitoring tools and dashboards... ...science subject matter expert on all Star measures (e.g., HEDIS, CAHPS, HOS, PartD). Translate CMS methodology into technical...HEDIS$119.31k - $178.97k
...organizational priorities and regulatory/quality programs (e.g., HEDIS, STARS) when applicable. Continuously enhance reporting tools... ...thinking, problem‑solving skills, and attention to detail. Excellent written and verbal communication skills. Preferred: 5+ years...HEDIS$22 per hour
...Description URGENTLY hiring a healthcare professional to support the hedis department at a well known medical group in Northridge, CA.... ...Administrative assistance, Microsoft, Clerical, Microsoft office, excel data entry Additional Skills & Qualifications: Copying,...HEDISTemporary workWork at officeImmediate start$24.55 - $28.35 per hour
...the team that drives continuous improvement, supports clinical excellence, and helps deliver high-quality care to every patient we serve.... ...updates to help care teams track Quality Improvement measures, HEDIS, GPRA, patient satisfaction, grants, and pay-for-performance programs...HEDISHourly payWork at officeLocal area$89.61k - $138.9k
...support changing demands associated with the job function. Effective sales/marketing and customer services techniques along with excellent writing and presentation skills. Ability to analyze bank statements to identify a prospective business member's needs and recommend...Work at officeWeekend workAfternoon shift- ...(CoM), Deputy Chief of Medicine (DCoM), Director of Nursing (DoN), Vice-President for HCC... ...Effectiveness Data and Information Set (HEDIS), etc. Ensures that HCCs maintain any current... ...to perform the essential functions. Excellent analytical and organizational skills,...HEDIS
- ...full scope of clinical practice. Utilizes excellent communication skills to ensure continuity... .... Identifies actual or potential health risks based upon observation of physiological... ...Planning, and Patient Experience. Captures HEDIS Quality Gaps during appointments...HEDISFull timePart timeWork at officeLocal areaWork from homeHome office
$90.86k - $136.29k
...Analytics. This role involves reviewing medical records to support HEDIS and other regulatory audits, training staff on HEDIS... ...Experience in HEDIS medical record review required. Experience in Excel and HEDIS audits. Desired: knowledge of medical record systems and...HEDISFull timePart timeWork at officeLocal areaWork from homeHome office$102.96k
...Overview The Risk Manager leads and supports the Risk Management Team. The Risk Manager... ...on all insurance products. Works with the Director of Risk Management to assess type of... ...and maintains relationships with claims adjusters, outside legal counsel, and other claims-...Contract workWork at office- ...to identify care gaps related to Stars, HEDIS, and Transitions of Care measures, prioritizing... .... Participate in center huddles, high‑risk rounds, and quality improvement projects... ...application of evidence‑based practices. Excellent communication and motivational...HEDISWork at officeMonday to Friday
$24 - $34 per hour
...liaison to lead and coordinate initiatives that drive performance in HEDIS, CMS Star Ratings (Part C & D), and overall health plan quality... ...Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team What You’ll Do Build and maintain...HEDISHourly payWork at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Director of Risk Adjustment & HEDIS Excellence. Be the first to apply!
- risk management specialist California, MO
- director of risk management California, MO
- risk management manager California, MO
- risk management associate California, MO
- operational risk manager California, MO
- director credit risk California, MO
- head of risk management California, MO
- technology risk California, MO
- risk underwriter California, MO
- risk assurance California, MO

