Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Lead Risk Adjustment QA & Auditing

Excellus BlueCross BlueShield

Excellus BCBS seeks a Supervisor, Risk Adjustment Quality Assurance and Auditing to lead the QA Auditor team, ensuring accuracy, compliance with CMS ICD-10-CM guidelines, and timely audits. This role provides coaching, training, and performance management while driving process improvements.

You will supervise daily QA activities, ensure coding accuracy, and oversee RADV and HRADV audits, partnering with leadership to enhance efficiency and maintain member privacy.

#J-18808-Ljbffr
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Lead Risk Adjustment QA & Auditing in Rochester, NY vacancy
  • $171k - $310k

     ...to work and build a career, KPMG provides audit, tax and advisory services for organizations...  ...Associate Managing Director, KDN Solution Lead - AI to join our KPMG Delivery Network...  ...stakeholder management, AI governance, and risk management, including defining governance... 
    Risk
    H1b
    Local area
    Immediate start

    KPMG

    Rochester, NY
    5 days ago
  • $250k

     ...opportunity The Global Pricing CoE Lead is responsible for advancing...  ...pursuits spanning top‑end audit, transformation, and managed services...  ...the firm's largest, highest-risk, and most complex global...  ...loss aversion, anchoring and adjustment, cognitive load, framing, and... 
    Risk
    Contract work
    Summer holiday
    Local area
    Flexible hours

    EY

    Rochester, NY
    2 days ago
  • $62 - $90 per hour

     ...ensure safe and thorough planning and testing, so we can manage risk and safeguard ongoing operations.ResponsibilitiesThis individual...  ..., color, and peripheral vision, depth perception and ability to adjust focus.The physical demands described here are representative of... 
    Risk
    Full time
    Part time
    Local area

    TRC Companies

    Rochester, NY
    2 days ago
  • $144.3k - $265.6k

     ...) PMO team, you will leverage leading program and project management...  ...Advisory & Assurance, Tax, or Audit—or a designated Enterprise Solutions...  ...teams in the delivery of high-risk, complex strategic programs/...  ...range estimate has not been adjusted for the applicable geographic... 
    Risk
    Work at office
    Remote work
    Work from home
    Visa sponsorship

    Deloitte

    Rochester, NY
    6 days ago
  •  ...how we make confident, well-governed decisions about third-party risk across a large, complex vendor ecosystem. You’ll turn technical...  ...makers. Experience improving documentation and evidence standards for issue closure and audit-ready reporting. #J-18808-Ljbffr... 
    Risk

    JPMorgan Chase & Co.

    Rochester, NY
    3 days ago
  • $127.2k - $246.9k

     ...for being a great place to work and build a career, KPMG provides audit, tax and advisory services for organizations in today's most...  ...team.KPMG is currently seeking a Manager, Security Governance, Risk and Compliance to join our Enterprise Security Services organization... 
    Risk
    H1b
    Local area

    KPMG

    Rochester, NY
    6 days ago
  • $95.68k - $143.52k

     ...measures, accreditation requirements, and regulatory performance. Leads multidisciplinary teams in initiatives that address identified...  .... Identifies trends, variations, documentation gaps, compliance risks, and opportunities for clinical improvement. Interprets clinical... 
    Risk
    Hourly pay
    Full time
    Local area
    Shift work

    001 University of Rochester

    Rochester, NY
    5 days ago
  • $116k - $174k

     ...WWT today! What will you be doing? The Lead Analyst uses a broad range of functional...  ...through innovative solutions. Risk Management: Evaluate and manage risks associated...  ...require accessibility accommodation(s) or adjustment during any stage of the hiring process,... 
    Risk
    Full time
    Remote work
    Flexible hours
    Shift work

    World Wide Technology

    Rochester, NY
    4 days ago
  • $180k - $245k

     ...adhered to, delivered, and audited with a level of quality...  ....As one of the world’s leading professional services...  ...external events and risk contingencies, ensuring...  ..., and adherence to the QA/QC plan.Provide verbal...  ...detail, multi-tasking, and adjusting readily to the changing... 
    Risk
    Contract work
    For subcontractor
    Local area
    Remote work
    Flexible hours

    WSP Group

    Rochester, NY
    7 days ago
  •  ...reach across disciplines and borders to develop and lead global initiatives. We deliver strategic...  ...so, we invite you to shape the future of digital Audit & Assurance at a world-class organization. As a Technology Risk & Compliance (TRC) Manager within our Global Audit... 
    Risk
    Visa sponsorship

    Deloitte

    Rochester, NY
    6 days ago
  •  ...proactively identifying and mitigating emerging risks.Reporting regularly to the Board of...  ...Company's established risk appetite. The role leads the Compliance Committee and serves on key...  ...identified through monitoring, testing, audit and/or examination processes.Cross... 
    Risk
    Temporary work
    Interim role

    Five Star Bank

    Rochester, NY
    5 days ago
  •  ...expertise to JPMorgan Chase. As part of Risk Management and Compliance, you are at the...  ...scenario design, conceptualizing and leading AI/LLM initiatives that help extract value...  ...submission package, with clear documentation and auditability. Maintain process governance,... 
    Risk
    Visa sponsorship

    JPMorgan Chase & Co.

    Rochester, NY
    16 hours ago
  •  ...and machine learning technologies to develop new products, improve productivity, and enhance risk management, effectively and responsibly. As a Vice President / Research Lead in AI Research, you will work on developing novel techniques, tools, and frameworks to model... 
    Risk
    Work experience placement
    Work at office
    Shift work

    JPMorgan Chase & Co.

    Rochester, NY
    1 day ago
  •  ...international regulations and ethical guidelines. Problem-solve and make critical decisions regarding trial design, vendor selection, and risk management. Your Profile: You will have solid clinical trial management experience, with the ability to manage competing... 
    Risk
    Local area
    Worldwide

    ICON Strategic Solutions

    Rochester, NY
    3 days ago
  •  ...Keller Executive Search is partnering with a leading manufacturing organization to appoint an experienced Quality Systems and Risk Management Manager. This is a pivotal role...  ...ready to shape quality strategy, strengthen audit readiness, and embed a culture of continuous... 
    Risk
    Contract work
    Casual work
    Local area
    Remote work
    Relocation
    Relocation package

    Keller Executive Search

    Rochester, NY
    23 days ago
  • $96.6k - $185k

     ...for being a great place to work and build a career, KPMG provides audit, tax and advisory services for organizations in today's most...  ...our team.KPMG is currently seeking a Manager, Content Marketing (Risk) to join our Clients and Markets organization.Responsibilities:Partner... 
    Risk
    Contract work
    H1b
    Local area

    KPMG

    Rochester, NY
    6 days ago
  • $135.9k - $220k

     ...Job Description Building and leading a team to deliver technology products and services that meet business outcomes. The role involves...  ...application performance in production, ensuring all relevant risk, financial, and compliance policies are met. Manage relationships... 
    Risk
    Shift work
    Day shift

    Bank of America

    Rochester, NY
    5 hours ago
  •  ...Quidel Corporation and Ortho Clinical Diagnostics, creating a world-leading in vitro diagnostics company with award-winning expertise in...  ...on supplier quality, total cost and performance while minimizing risk exposure. Partner with supply chain and finance teams such that... 
    Risk
    Contract work
    Work at office
    Remote work
    Shift work

    QuidelOrtho

    Rochester, NY
    5 hours ago
  •  ...Better Community, Inc. in Rochester, NY, is seeking a High Impact Prevention Program Coordinator to lead a team delivering HIV prevention and related services to high-risk populations. This role emphasizes supervision, program administration, data reporting, staff... 
    Risk

    Action

    Rochester, NY
    4 days ago
  • $127.2k - $246.9k

     ...for being a great place to work and build a career, KPMG provides audit, tax and advisory services for organizations in today's most...  ...join our team.KPMG is currently seeking a Manager, Third-Party Risk to join our Global Operations Group which is part of KPMG International... 
    Risk
    H1b
    Local area

    KPMG

    Rochester, NY
    5 days ago
  •  ...Alvarez & Marsal is seeking a Director to lead complex valuation engagements across securities, including loans and equity. You will evaluate...  ...manage engagements end-to-end, including resources, budgets, risk controls, and delivery of reports. Strong modelling, Excel/VBA,... 
    Risk

    Alvarez & Marsal

    Rochester, NY
    3 days ago
  • $171k - $311k

     ...to work and build a career, KPMG provides audit, tax and advisory services for...  ...ensuring processes strictly adhere to business, Risk Management, Independence, and Office of General...  ...of and ability to advocate for leading contract lifecycle management practices,... 
    Risk
    Contract work
    Temporary work
    H1b
    Work at office
    Local area

    KPMG

    Rochester, NY
    6 days ago
  • As the Field Examination Lead in the Asset-Based Lending (ABL) Field Examination team, you...  ...promote rigorous collateral and credit risk assessments, collaborate with senior credit...  ...experience in ABL field examination, collateral audit, public accounting, or credit risk with... 
    Risk
    Seasonal work

    JPMorgan Chase & Co.

    Rochester, NY
    3 days ago
  • $116.5k - $216.5k

     ...cyber domains in the interest of national security. Job Title: Lead, IT Business Analysis (Program Delivery Lead) Job Code: 45640...  ...communicate status of enhancement requests, project milestones, risks, issues, dependencies, and deliverables to stakeholders and... 
    Risk
    Local area
    Flexible hours

    L3Harris Technologies, Inc.

    Rochester, NY
    2 days ago
  • $153k - $297k

     ...to work and build a career, KPMG provides audit, tax and advisory services for organizations...  ...organization.Responsibilities:Build and lead anenterprise cybersecurity countermeasures...  ...clear ownership, service-level objectives, risk-basedprioritization, exception management,... 
    Risk
    Temporary work
    Interim role
    H1b
    Local area

    KPMG

    Rochester, NY
    6 days ago
  • $86.4k - $135k

    Lead Production PlannerStatus: Exempt (salaried) Department: OperationsPosition SummaryThe Lead Production Planner takes the lead role...  ...and capacity requirements and communicating supply constraints, risks, and recovery actions necessary to support customer and revenue... 
    Risk
    Full time
    Work at office
    Local area

    Plug Power

    Rochester, NY
    5 days ago
  • $100k - $155k

     ...Audit Engagement ManagerExamine, analyze, and interpret accounting records to prepare financial...  ...our clients' current and future growth!Lead and manage multiple existing audit...  ...with established audit procedures. Perform risk assessments and develop comprehensive audit... 
    Risk
    Flexible hours

    Bowers CPAs & Advisors

    Rochester, NY
    4 days ago
  • $106k - $159k

     ...What we are looking forWe are seeking a Mechanical Engineering Team Lead to guide our roll-to-roll web conveyance team and deliver complex...  ...Develop project plans, schedules, proposals, cost estimates, and risk-mitigation strategies.Partner with clients and internal teams to... 
    Risk

    Re:Build Manufacturing

    Rochester, NY
    6 days ago
  •  ...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... 
    Risk
    Worldwide

    Starr Indemnity & Liability Company

    Rochester, NY
    2 days ago
  •  ...in Rochester, NY is seeking a Manager of Leave Administration to lead the day-to-day administration of FMLA, PFL, disability, military...  ...educate staff, and collaborate with payroll and operations to minimize risk and cost while supporting business needs. #J-18808-Ljbffr... 
    Risk

    Rochester Regional Health

    Rochester, NY
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Lead Risk Adjustment QA & Auditing. Be the first to apply!