Risk Adjustment & Quality Records Director - Remote
Humana Inc
Sacramento, CA
- Remote job
Humana Inc. is seeking a Director of Risk Adjustment & Quality Record Retrieval to lead a national remote team, optimize retrieval operations, and drive compliance across risk, quality, and regulatory initiatives. The role emphasizes collaboration with Risk Adjustment, Stars, and leadership to deliver measurable results. The position requires sophisticated leadership, strategic thinking, and the ability to manage large, dispersed teams while navigating evolving industry changes. #J-18808-Ljbffr Humana Inc
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Risk Adjustment & Quality Records Director - Remote in Sacramento, CA vacancy
$150k - $206.3k
Humana Inc is looking for a Director of Risk Adjustment & Quality Record Retrieval to lead a national remote team of 300 associates. The role involves managing retrieval operations, driving performance through data-informed decisions, and fostering collaboration across...Remote jobRisk- Humana Inc is seeking a Director of Risk Adjustment & Quality Record Retrieval based in Hartford, CT, to lead a team of 300. This role involves managing operations focused on medical record retrieval, ensuring process optimization and effective communication across the...Remote jobRisk
- Humana Inc. is seeking a Director of Risk Adjustment & Quality Record Retrieval to lead a national, remote workforce of 300 associates and drive all retrieval operations tied to Risk Adjustment and Quality priorities. The role focuses on performance management, escalation...Remote jobRisk
- A leading insurance and risk management firm is seeking a Claims Adjuster in Dallas, Texas. The ideal candidate will have 3-5 years of experience managing lost... ...compensation package and the possibility for remote work. Join a team committed to making a difference during...Remote workRisk
Arthur J. Gallagher & Co.
Dallas, TX1 day ago - ...Associate responsible for delivering high-quality risk adjustment coding services for clients. This role requires reviewing medical records, assigning diagnosis codes, and ensuring... ...for professional growth. This is a fully remote role based in the United States. #J-18808...Remote workRisk
Intus Care
New York, NY4 days ago $54.3k - $145.86k
...direction of the Senior Manager of the RI Retro Ops Team, the Risk Adjustment Outreach Manager is responsible for leading initiatives that... ...retrieval efforts and achieve organizational goals. ~This is a remote position within the continental US. What you will do:...Remote workRiskFull timeCVS Health
Remote1 day ago- ...Manager Risk Adjustment Program At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists... ...clinical excellence. Position details: Location: Tampa, FL (Remote - Must Reside in the State of Florida) Status: Full Time,...Remote workRiskFull timeShift work
BayCare
United States10 days ago - 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...Remote jobRiskLocal area
$31.03 - $36.03 per hour
...required work experience. ~3 years of risk adjustment and/or hierarchical condition category... ...and coding moderately complex medical records. Experience working with vendors, providers... ...coding discrepancies and supporting quality and provider education initiatives....Remote workRiskTemporary workWork experience placementCynet Systems
United States3 days ago$89.17k - $142.68k
Blue Cross and Blue Shield of North Carolina is seeking a highly skilled Senior Data Analyst who specializes in ACA Risk Adjustment and EDGE submissions. You will act as a liaison between business and technical teams to ensure data accuracy and reporting. This role requires...Remote jobRisk$89.17k - $142.68k
Blue Cross and Blue Shield of North Carolina is seeking a Senior Data Analyst with expertise in ACA Risk Adjustment and EDGE data submissions. The role requires strong experience in data flows and analytical validation. You'll prepare complex data for various stakeholders...Remote jobRisk$27.02 - $41.85 per hour
...Highmark Health, located in Trenton, NJ, is seeking an HCC Coding Specialist who will deliver value through coding processes for Risk Adjusted government programs. This role requires at least 3 years of experience in HCC coding and requires a CPC, CRC, CCS, or RHIT...Remote workRiskHourly payHighmark Health
Ewing, NJ1 day ago- Blue Cross and Blue Shield of North Carolina is seeking a Senior Data Analyst in Durham. This role focuses on ACA Risk Adjustment and EDGE server submissions. The candidate will work with stakeholders to ensure accurate data reporting and provide complex analytic support...Remote jobRisk
$33.69 - $56.15 per hour
Role Description As a Senior Risk Adjustment Informatics & Workflow Analyst, you will design and maintain workflows that support Banner’s... ...documentation is audit-ready and defensible. This is a remote opportunity with a schedule of Monday-Friday, 8 hour shifts....Remote workRiskFull timeMonday to FridayShift workBanner Health
Remote1 day ago- ...Senior Product Manager to lead the strategy and execution of a risk adjustment product. The ideal candidate should have 5-7 years of... ...across teams to enhance product offerings. The position is fully remote and offers a competitive salary and comprehensive benefits. #J...Remote jobRisk
- Oscar Health is hiring an Associate, Risk Adjustment Auditor for their Risk Adjustment team. This remote role requires conducting quality audits specific to ICD-10 code abstraction and ensuring compliance with coding standards. The ideal candidate holds a Bachelor's degree...Remote jobRisk
$89.17k - $142.68k
Blue Cross and Blue Shield of North Carolina is seeking a Senior Data Analyst with expertise in Affordable Care Act Risk Adjustment. The candidate will collaborate with stakeholders to ensure the accuracy of EDGE data submissions. This role requires strong analytical skills...Remote jobRisk$27.02 - $41.85 per hour
...coding to support Medicare Advantage and ACA programs. This role focuses on accurate risk adjustment coding, regulatory audits, and continuous improvement initiatives within a remote work environment. Candidates should have at least 3 years of coding experience and the...Remote workRiskHourly payHighmark Health
Bismarck, ND9 hours ago$82.72k - $108.57k
Oscar is hiring an Associate, Risk Adjustment Auditor to join our Risk Adjustment team. This role involves conducting quality audits related to ICD-10 code abstraction and working... ...quality assurance programs. This is a remote position available to candidates from select...Remote jobRisk$27.02 - $41.85 per hour
...Phoenix, Arizona, is seeking an HCC Coding Specialist to support Risk Adjusted government programs like Medicare Advantage. The ideal... ...audits, and improving documentation processes. The role allows for remote work and offers a pay range of $27.02 to $41.85 per hour, depending...Remote workRiskHourly payHighmark Health
Phoenix, AZ1 day ago- A public agency in California is seeking a Workers' Compensation Claims Adjuster II to join the Risk Management team. This role involves investigating claims, administering benefits, and working closely with legal counsel. The County values a diverse workforce and offers...Remote jobRisk
- Role Description Director, Product Manager - Risk Adjustment (Remote) About the Role: ~Type: Full-Time, Salaried... ...clinician experience and documentation quality. ~Partnering with Clinical,... ..., NLP, longitudinal patient records, audit analytics, and risk prediction...Remote workRiskFull timeTemporary workFlexible hours
Matrix Medical Network
Remote4 days ago - ...for a Senior Data Analyst skilled in Affordable Care Act (ACA) Risk Adjustment. This role will be essential in ensuring the accuracy and... ...employees. This position supports a hybrid work model that balances remote work with in-office collaboration. Competitive salary,...Remote jobRiskWork at office
$7,379.78 - $8,970.17 per month
...Martinez, California Department: Risk Management Job Title: Workers' Compensation Claims Adjuster II Contra Costa County is... ...approach is one that prioritizes the quality of service to our internal... ...dynamic team We offer a hybrid remote work schedule You will have access...Remote workRiskHourly payPermanent employmentFull timeTemporary workPrismrisk
Martinez, CA1 day ago- ...primary resource for assigned providers, guiding documentation and risk adjustment capture with education and specialized guidance. The role... ...delivery, and support for coding tools, in a hybrid/remote setup with local travel within Virginia. #J-18808-Ljbffr CenterWell...Remote workRiskLocal area
- ...Humana is looking for a Risk Adjustment Coder to conduct quality assurance coding of medical records and ICD-10 diagnosis codes. Your role will include reviewing medical records, ensuring accurate coding in compliance with regulations, and possibly making calls to providers...Remote workRisk
Humana
Columbus, OH9 hours ago - Oscar Health is hiring a remote Associate, Risk Adjustment Auditor to join their Risk Adjustment team. This role involves conducting internal and external quality audits specific to ICD-10 code accuracy. The ideal candidate will have experience in risk adjustment coding...Remote jobRisk
$82.72k - $108.57k
Oscar is seeking an Associate, Risk Adjustment Auditor for a remote role to conduct internal and external quality audits focusing on ICD-10 code abstraction. The role requires collaboration with management to establish benchmarks and quality assurance programs. This position...Remote jobRisk- ...for assigned providers to ensure accurate documentation and risk adjustment capture. The role includes quarterly reviews, targeted education... ..., with travel within the defined market. Facilities a hybrid/remote work model, with standard hours and quarterly travel as...Remote jobRisk
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Risk Adjustment & Quality Records Director - Remote. Be the first to apply!
Related searches
- risk management associate Sacramento, CA
- head of risk management Sacramento, CA
- risk management specialist Sacramento, CA
- director credit risk Sacramento, CA
- risk management manager Sacramento, CA
- operational risk manager Sacramento, CA
- director of risk management Sacramento, CA
- senior manager quality engineering Sacramento, CA
- director of quality Sacramento, CA
- quality supervisor Sacramento, CA