Risk Adjustment & RAF Performance Lead
Upward Health
Upward Health in Houston is seeking a Manager of Risk Adjustment to oversee risk adjustment operations and enhance RAF and Medicaid risk score accuracy. This position manages reporting, data oversight, and performance initiatives collaborating with Quality and Clinical Operations teams. The ideal candidate has over 5 years of experience in risk adjustment or population health, with proven success in analytics and process improvement. Join a multidisciplinary team dedicated to delivering comprehensive patient care. #J-18808-Ljbffr Upward Health
- ...focus This role is critical to advancing the organization’s risk adjustment performance by supporting accurate, timely, and sustainable... ...operational processes, and performance initiatives that strengthen RAF and Medicaid risk score accuracy and support sustainable value...Risk
- ...seeking a high‑caliber Practice Performance Manager (PPM) to serve as a... ...quality improvement, risk adjustment, population health analytics,... ...Improve HCC capture accuracy and RAF score accuracy through targeted... ...Optimization & Workflow Redesign Lead comprehensive workflow design...RiskContract workWork at officeRemote workShift work
$80k - $90k
Provider Relations - Market Performance Lead Department: Provider Relations Employment Type: Full Time Location: 19500 HWY 249, Suite... ...physician practices, supporting improvements in clinical quality, risk adjustment, operational efficiency, and financial performance. This...RiskFull timeWork at officeRemote work- ...productivity standards. Candidates need a high school diploma, relevant certifications, and at least three years of experience in risk adjustment. AAPC or AHIMA credential is required. The role also values attention to detail and knowledge in managed care. #J-18808-Ljbffr...Risk
$70k - $85k
Risk Adjustment Coding Specialist II - Beaumont, Texas Department: Quality - Risk Adjustment... ...Additionally, you’ll track and report on key performance metrics—such as HCC recapture rates,... ...as requested by manager May assist or lead projects and/or higher work volume than...RiskFull timeWork at office- ...Manager to drive health, safety, and environmental performance across the organization. The role involves leading HSE personnel, managing key performance indicators... ...safety and effective communication in both high-risk and client-facing situations. #J-18808-Ljbffr H+M...RiskWork at office
$70k - $85k
A healthcare organization is seeking a Risk Adjustment Coding Specialist II to support risk adjustment efforts in Beaumont, Texas. The ideal candidate will have 3-5 years of experience in risk adjustment coding and should be capable of conducting chart reviews, educating...Risk$70k - $85k
Astrana Health Management in Houston, Texas seeks a Risk Adjustment Coding Specialist II to support risk adjustment efforts through high-volume coding reviews. The role requires 3-5 years of coding experience, strong communication skills, and AAPC or AHIMA certification...RiskFull time- 340B Health is seeking a Risk Adjustment Coder II to provide advanced support for medical record reviews and ensure accurate capture of chronic conditions. This role involves coding according to CMS guidelines and improving documentation standards. The ideal candidate will...Risk
- Community Health Choice is looking for a Risk Adjustment Coder II to manage complex medical record reviews to ensure accurate patient risk score captures. The role requires expertise in mapping conditions to HCCs in compliance with CMS guidelines. Key responsibilities include...Risk
- Direct Jobs is seeking a Risk Adjustment Coder II in Houston, Texas. This role involves advanced support for medical record reviews, ensuring correct capture of chronic conditions and compliance with CMS guidelines. The Coder II acts as a subject matter expert, facilitating...Risk
- Community Health Choice, Inc. seeks a Risk Adjustment Coder II in Houston, Texas. The role involves advanced medical record reviews and coding of chronic conditions to ensure correct risk scoring, complying with CMS guidelines and internal policies. The ideal candidate...Risk
- ...and operations services and ensures the necessary IT risk management and security measures are in place and... ...standards and principles. **About The Role**The Tech Lead will be an integral part of the Sales Performance Management (SPM) Platform team. This role will help...RiskWork at officeLocal areaImmediate startRemote workRelocation
$300k
...Financial Services & Insurance Performance Assurance Analyst PRIMARY... ...to our clients; confirm our adjuster’s claim files comply with specific... ...opportunities to the Team Lead to meet established operational... ...is the world’s leading risk and claims administration partner...RiskWork at officeLocal areaRemote work- ...community involvement. The ABM performs routine branch opening,... ...regulatory requirements. # Leads branch sales efforts and expands... ...vision, depth perception, and adjusted focus), speaking, hearing, listening... ...trends, assessing potential risks, and supporting strategic initiatives...RiskFull timeWork at officeLocal areaMonday to Friday
- ...Risk Adjustment Coder II The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition...RiskWork experience placement
- About The Role We are seeking a professional Property Claims Adjuster with a passion for customer service and a proven record of success... ...Handle subrogation on closed files. Appraise and assess new risks and some Catastrophe planning. Authority for making appropriate...Risk
- ...Insurance Commercial Property Claims Desk Adjuster — Remote after training PRIMARY... ...FUNCTIONS and RESPONSIBILITIES ~ Performs other duties as assigned. QUALIFICATIONS... ...roles. Sedgwick is the world’s leading risk and claims administration partner, which...RiskWork at officeLocal areaRemote work
- ...Director of Risk Management Primary focus on claims management, bonding, OSHA compliance... ...seeking a Director of Risk Management to lead the company’s efforts in managing... ...legal claims. Coordinate with legal counsel, adjusters, and internal stakeholders to ensure timely...RiskContract work
$75k - $85k
...An employer in the Houston, TX area is seeking a Training and Performance Manager to join their Operations team. This team is responsible... ...experience in the logistics industry Experience supporting high‑risk and high‑security shipments and customers Experience managing...RiskPermanent employmentRemote work- ...internal control policies, procedures, and guidelines to mitigate risks and ensure compliance with regulatory requirements. Assess the... ...best practices to ensure ongoing compliance and make necessary adjustments to internal control processes. Provide training and guidance to...Risk
- Catholic Mutual Group in Houston, TX, is seeking a Claims/Risk Manager to oversee property and casualty claims while supporting risk... .... Candidates should have at least five years of claims adjusting experience and strong communication skills. The role requires conducting...Risk
- ...Join to apply for the Manager - Project Risk role at Worley 1 day ago Be among the first... ...needed now. Purpose of the Role To lead and ensure consistent application of Risk... ...Manager, Airports/Aviation Sr Healthcare Risk Adjustment Analyst - Remote Houston, TX $102,890.67-...RiskFull timeWork at officeImmediate startRemote work
- ...looking for self‑motivated, experienced Field Adjusters for a long‑term opportunity in the... ...policyholders, public adjusters, and attorneys. Perform all phases of property claims adjusting,... ...property, identify damages, document the risk, and estimate the damages. Qualifications...RiskTemporary workWork at officeImmediate startWork from homeHome officeFlexible hours
- ...our ongoing success—take the lead in shaping your career development... ...Job Summary The Cybersecurity Risk Analyst supports the... ...essential. Demonstrated experience performing cybersecurity or technology risk... ...Level, Title and/or Salary may be adjusted based on the applicant’s...RiskContract workWork at office
- ...skills, along with hands‑on experience leading Agile teams as a Scrum Master.... ...communicate critical milestones, risks, action items, decisions, and dependencies... ...Monitor resource utilization and adjust as necessary to optimize project performance. Budget Oversight: Manage complex...RiskWork experience placementFlexible hours
- ...General Liability, Builder's Risk (including the Master Builders... ...Company's captive program. Lead annual insurance renewals and... ...completion dates and coverage adjustments and quarterly MBR reporting to... ...risk analysis, trade partner performance monitoring, and ongoing...RiskFull timeContract workFor contractorsFor subcontractorWork at officeLocal areaMonday to Friday
- ...experience as an IT Project Manager leading 1-3 medium to large sized IT... ...Resource Management Project Risk / Issue Management Project... ...regarding various project aspects and adjusts accordingly. Participates in... .... May revise as appropriate. Performs ongoing review of project...Risk
- ...effectiveness, succession, and people-related risk. This role is pivotal in exercising oversight of compensation, benefits, performance management, and core HR infrastructure, and... ...advisor to executive leadership, and leading HR transformation initiatives. The ideal candidate...Risk
$95.9k - $110.25k
...Salary : $95,900 - $110,250 The Manager, IT Planning, Projects & Performance leads the department's operational performance metrics and... ...areas, including monitoring project status, plans/milestones, risks, dependencies, resource needs, and deliverables. Establishes...Risk
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